Prevalence of and Factors Associated with Cesarean Delivery in Kigali, Rwanda: A Hospital-Based Cross-Sectional Study

Cesarean delivery is rising globally, and Sub-Saharan Africa is no exception.

This study investigated the prevalence and factors associated with cesarean delivery in Kigali, Rwanda.

This hospital-based cross-sectional study was carried out in two hospitals in Kigali, Rwanda. A questionnaire was used to collect sociodemographic and obstetrical data, including mode of delivery. Weight, height, and hemoglobin level were measured using standard procedures. Multivariate binary analysis was performed.

In this study, 445 pregnant women were included. The median (interquartile [IQR]) age and parity were 30.0 (26.0‒35.0) years and 1.0 (0.0‒3.0), respectively. One hundred and eleven (24.9%) women were delivered via cesarean, of whom 66 (59.5%) were delivered via emergency cesarean and the remaining 45 (40.5%) via elective cesarean. In multivariate logistic regression, maternal age (adjusted odds ratio [AOR] = 1.11, 95% confidence interval [CI] 1.05‒1.16), having a husband with educational attainment of secondary or less (AOR = 1.73, 95% 1.08‒2.80), and a history of miscarriage (AOR = 3.77, 95% CI 2.02‒7.03) were significantly associated with cesarean delivery. There was no significant association between cesarean delivery and parity, anemia, or low birth weight.

One out of four pregnant women in Kigali was delivered via cesarean regardless of their parity. Age and history of miscarriage can be used as a predictor for cesarean delivery in Rwanda. Additional socio-epidemiological research is recommended to explore the impact of increasing maternal age without an increase in parity and low educational levels among husbands on the mode of delivery in Rwanda.