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Using Robson's Ten-Group Classification System for comparing caesarean section rates in Europe: an analysis of

J Zeitlin1, M Durox1, A Macfarlane2

  • 1CRESS, Obstetrical Perinatal and Paediatric Epidemiology Research Team, EPOPe, INSERM, INRA, Universite de Paris, Paris, France.

BJOG : an International Journal of Obstetrics and Gynaecology
|December 18, 2020
PubMed
Summary
This summary is machine-generated.

Robson's Ten Group Classification System (TGCS) can be derived from routine European data, enabling better monitoring of caesarean birth rates. Countries with robust data systems show lower caesarean rates, indicating effective policy implementation.

Keywords:
Caesarean birthEuropeRobson classificationTen-Group Classification Systemhealth information systemsperinatal health indicators

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Area of Science:

  • Obstetrics and Gynecology
  • Public Health
  • Health Services Research

Background:

  • Caesarean birth rates vary significantly across Europe.
  • Standardized methods for monitoring and comparing these rates are crucial for public health initiatives.
  • Robson's Ten Group Classification System (TGCS) offers a standardized approach to stratify caesarean births.

Purpose of the Study:

  • To assess the feasibility of deriving TGCS from routine data across European countries.
  • To analyze national caesarean birth rates using TGCS.
  • To identify potential correlations between data availability and caesarean rates.

Main Methods:

  • An observational study utilizing routine data from 27 EU member states, Iceland, Norway, Switzerland, and the UK.
  • Data on caesarean births within TGCS groups were collected from national statistical offices and medical birth registers for births at ≥22 weeks gestational age in 2015.
  • Analysis focused on overall caesarean rates, prevalence, and TGCS group-specific rates.

Main Results:

  • 18 out of 31 countries could provide TGCS data; caesarean rates ranged from 16.1% to 56.9%.
  • Countries providing TGCS data exhibited lower caesarean rates (25.8%) compared to those without (32.9%, P=0.04).
  • Heterogeneity was observed in specific TGCS groups, highlighting potential issues with unstandardized definitions.

Conclusions:

  • TGCS can be derived from routine European data, offering valuable baseline and comparator data for surveillance.
  • The ability to construct TGCS may indicate a country's investment in evidence-based caesarean policies.
  • Further validation of data quality is recommended for robust international comparisons.