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Factors Associated with Cesarean Section in Tehran, Iran using Multilevel Logistic Regression Model
Payam Amini1, Maryam Mohammadi1, Reza Omani-Samani1
1Department of Epidemiology and Reproductive Health, Reproductive Epidemiology Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran.
Osong Public Health and Research Perspectives
|May 10, 2018
Summary
Cesarean section (CS) rates in Tehran are alarmingly high at 72.0%. Risk factors include maternal age, socioeconomic status, and preeclampsia, necessitating interventions to reduce cesarean birth rates in Iran.
Area of Science:
- Obstetrics and Gynecology
- Public Health
- Epidemiology
Background:
- Global cesarean section (CS) rates have significantly increased.
- Iran exhibits a particularly high prevalence of CS.
- Understanding local risk factors is crucial for targeted interventions.
Purpose of the Study:
- To determine the prevalence of cesarean sections in Tehran.
- To identify associated risk factors for CS in the study population.
Main Methods:
- Cross-sectional study of 4,308 pregnant women in Tehran (July 2015).
- Multilevel logistic regression analysis incorporating demographic, obstetrical, and hospital-level variables.
- Analysis of factors influencing singleton live-births.
Main Results:
- The incidence of CS was 72.0%.
- Significant risk factors identified include maternal age, socioeconomic status, BMI, parity, pregnancy type, preeclampsia, infant height, and head circumference.
- Hospitals accounted for approximately 29.2% of the variation in CS rates (ICC=0.292).
Conclusions:
- The CS rate in Tehran is substantially higher than in many other countries.
- Educational and psychological interventions are recommended to lower CS rates among Iranian women.
- Addressing identified risk factors is essential for public health initiatives.
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