Pattern of Live Births in Rio de Janeiro State, Brazil, According to Robson Groups and the Kotelchuck Index...

Area of Science:

• Obstetrics and Gynecology
• Public Health
• Health Services Research

Background:

• Hospital birth patterns in Rio de Janeiro (RJ), Brazil, require investigation.
• Understanding these patterns is crucial for improving maternal and child health outcomes.
• The Robson classification and Kotelchuck index provide frameworks for analyzing birth characteristics and prenatal care.

Purpose of the Study:

• To analyze hospital birth patterns in Rio de Janeiro between 2015-2016.
• To evaluate birth patterns using the Robson classification and Kotelchuck prenatal care index.
• To identify factors associated with cesarean section (C-section) rates.

Main Methods:

• Utilized data from the Information System on Live Births (SINASC/DATASUS) for 2015-2016.
• Categorized births using the Robson classification.
• Performed descriptive analysis and logistic regression for cesarean section risk factors.

Main Results:

• Over 60% of 391,961 analyzed live births in RJ were C-sections.
• Robson groups 5, 2, and 3 comprised the majority of births.
• Higher C-section rates than expected were observed in Robson groups 1, 2, 3, 4, 5, and 8.
• Inadequate prenatal care, lack of a partner, and lower socioeconomic status were linked to vaginal deliveries.
• Increased maternal age, presence of a partner, and improved prenatal care correlated with higher C-section odds within Robson groups.

Conclusions:

• Evidence suggests non-clinical factors significantly influenced C-section rates in RJ from 2015-2016.
• Cesarean delivery patterns may not always align with clinical necessity.
• Further research into the drivers of C-section decisions is warranted.