Swiss caesarean section rates according to Robson's Ten-Group Classification System: an observational study

Area of Science:

• Obstetrics and Gynecology
• Public Health
• Health Services Research

Background:

• Robson's Ten-Group Classification System (TGCS) standardizes caesarean section (CS) rate reporting.
• Understanding CS rates is crucial for maternal and neonatal health outcomes.
• International comparisons of CS rates require standardized classification systems.

Purpose of the Study:

• To analyze Swiss caesarean section rates using Robson's Ten-Group Classification System (TGCS).
• To stratify CS rates by Swiss region and healthcare facility type.
• To compare Swiss CS rates with World Health Organization (WHO) recommendations.

Main Methods:

• Observational study of 695,733 deliveries in Switzerland (2014-2021).
• Utilized routine data from the Swiss Federal Statistics Office for classification.
• Stratified CS rates by canton and hospital typology.

Main Results:

• Groups 2 (nulliparous, >37 weeks, induced) and 5 (previous CS, >37 weeks, singleton) were major CS contributors (20.7% and 30.1%).
• Swiss CS rates exceeded WHO recommendations for Groups 2 (44.4% vs 39.9%) and 5 (86.0% vs 74.4%).
• Significant variations in CS rates were observed across cantons and facility types.

Conclusions:

• Routine data enabled TGCS-based description of Swiss CS rates.
• Swiss CS rates are higher than WHO recommendations despite comparable populations.
• Substantial regional and facility-level disparities in CS rates exist within Switzerland.