Robson ten-group classification-based analysis of caesarean sections in Türkiye: a large-scale cross-sectional study

Area of Science:

• Obstetrics and Gynecology
• Public Health
• Health Services Research

Background:

• Rising global Caesarean section (C-section) rates necessitate standardized monitoring.
• The World Health Organization (WHO) recommends the Robson 10-group classification system (RTGCS) for C-section rate standardization.
• This study addresses increasing C-section rates in Türkiye.

Purpose of the Study:

• To evaluate C-section rates at a Turkish tertiary referral center.
• To identify specific Robson groups contributing most to C-section rates.
• To inform clinical quality improvement initiatives for obstetric practices.

Main Methods:

• Retrospective analysis of 119,767 deliveries over 12 years (July 2012 - October 2024).
• Stratification of deliveries using the Robson 10-group classification system (RTGCS).
• Statistical analysis including independent t-tests and Pearson's chi-squared tests.

Main Results:

• Overall C-section rate was 47.6% (56,986/119,767 deliveries).
• Higher C-section rates observed among Turkish nationals (49.6%) compared to refugees (36.4%).
• Robson Group 5 contributed most to C-sections (21.0%), followed by Groups 10 (5.5%), 3 (5.8%), and 1 (5.9%). Groups 1, 3, 5, and 10 accounted for 80.2% of all C-sections.

Conclusions:

• The overall C-section rate in the study cohort was 47.6%.
• Robson Group 5 was the largest contributor to C-section volume, followed by Groups 10, 3, and 1.
• Findings highlight specific groups for targeted interventions to reduce C-section rates.