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Association between Robson classification groups and cesarean delivery: a longitudinal analysis in Mongolia
Ulambayar Shinejil1, Junko Kiriya1, Akira Shibanuma1
1Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
AJOG Global Reports
|October 24, 2022
Summary
Cesarean delivery rates changed significantly between 2008 and 2018, with higher odds in Robson group 1 and lower odds in groups 2-4. Group 5 had the highest cesarean delivery odds, indicating a need for intervention.
Area of Science:
- Obstetrics and Gynecology
- Public Health
- Maternal Health
Background:
- Global cesarean delivery rates have risen significantly over the past three decades.
- The World Health Organization endorses the Robson classification for monitoring and reducing cesarean rates.
Purpose of the Study:
- To analyze the association between Robson classification groups and cesarean delivery at Urguu Maternity Hospital in 2008 and 2018.
- To evaluate changes in this association over a 10-year period.
Main Methods:
- Cross-sectional study utilizing electronic birth records from 21,225 participants (2008: 9544, 2018: 11,681).
- Categorization of births into 10 Robson classification groups.
- Multiple logistic regression analysis to assess the association between Robson group and cesarean delivery rates, including pooled data analysis for temporal changes.
Main Results:
- Cesarean delivery odds increased in Robson group 1 (aOR 3.02) in 2018 compared to 2008.
- Cesarean delivery odds decreased in Robson groups 2 (aOR 0.66), 3 (aOR 0.21), and 4 (aOR 0.33) in 2018 versus 2008.
- Robson group 3 had the lowest cesarean delivery odds, while group 5 consistently had the highest odds in both years.
Conclusions:
- The high cesarean delivery rate in Robson group 5 highlights the need for strategies to encourage vaginal birth after cesarean (VBAC).
- Further research is required to identify factors contributing to the rising cesarean delivery rates.
