Caesarean section rates from Malaysian tertiary hospitals using Robson's 10-group classification

Area of Science:

• Obstetrics and Gynecology
• Public Health
• Epidemiology

Background:

• Global concern over increasing caesarean section rates.
• Need to identify contributing factors in specific healthcare settings.
• Robson's ten group classification as a standardized tool.

Purpose of the Study:

• Utilize Robson's classification to analyze caesarean section drivers in Malaysian tertiary hospitals.
• Compare caesarean section rates and trends across different hospitals.
• Identify specific patient groups contributing to rising rates.

Main Methods:

• Cross-sectional study design over 5 years (2011-2015).
• Utilized data from the Malaysian National Obstetrics Registry (NOR).
• Included 608,747 deliveries from 12 tertiary hospitals.

Main Results:

• Overall caesarean section rate was 23.2% (141,257 cases).
• Increasing trends observed in Group 1 (nulliparous, spontaneous labor) and Group 3 (multiparous, spontaneous labor).
• Group 5 (multiparous, singleton, cephalic, previous C-section) was the largest contributor to overall rates.

Conclusions:

• Caesarean section rates are rising globally, driven by low-risk groups.
• Significant variations in rates exist between hospitals.
• Policy and training standardization across hospitals are recommended to address this trend.