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

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Swiss caesarean section rates, analyzed using Robson

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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.