Caesarean section trends in Catalonia between 2013 and 2017 based on the Robson classification system: A...

Area of Science:

• Obstetrics and Gynecology
• Public Health
• Health Services Research

Background:

• Caesarean section (CS) rates in Catalonia were previously analyzed as a single percentage.
• The Robson classification offers a standardized method for analyzing CS rates across different obstetric populations.

Purpose of the Study:

• To estimate caesarean section rates using the Robson classification in publicly funded hospitals in Catalonia from 2013 to 2017.
• To analyze CS rates considering sociodemographic, institutional, and obstetric characteristics.

Main Methods:

• A cross-sectional, population-based study included 210,020 deliveries in Catalan public hospitals (2013-2017).
• The modified Robson classification distribution was estimated.
• Logistic regression models were used to analyze CS rates and their contribution, adjusted for confounders.

Main Results:

• Overall CS rates decreased from 24.3% to 22.8% between 2013 and 2017.
• After adjusting for confounders, the decline was more pronounced (aOR 0.87).
• Specific Robson groups (1+2, 3+4, 10) showed significant CS rate reductions, while group 5 did not.

Conclusions:

• The adjusted decrease in CS rates suggests potential past overutilization.
• Despite the decline, rates remain above expert recommendations.
• Further improvements in obstetric data collection are needed to achieve optimal CS rates.