Are operative delivery procedures in Greece socially conditioned?

Area of Science:

• Obstetrics and Gynecology
• Public Health
• Health Services Research

Background:

• Caesarean section (CS) rates have significantly increased globally and in Greece.
• Understanding factors influencing operative delivery is crucial for maternal and infant outcomes.
• Primiparous mothers represent a key demographic for studying delivery interventions.

Purpose of the Study:

• To investigate medical and socioeconomic factors associated with Caesarean section (CS) and operative vaginal delivery (OVD) in primiparous mothers in Athens, Greece.
• To compare the utilization of CS and OVD between public and private hospitals.
• To identify potential disparities in operative delivery practices.

Main Methods:

• A case-control study comparing 444 CS, 130 OVD, and 1235 normal deliveries.
• Inclusion criteria: singleton, liveborn babies of primiparous mothers.
• Data analysis using multiple logistic regression to control for confounding variables.

Main Results:

• CS was associated with maternal age, height, weight, high/low birth weight, obstetric complications, and in-vitro fertilization (IVF).
• OVD showed a similar pattern but was not linked to maternal overweight or IVF.
• CS rates were double in public teaching hospitals compared to private ones; OVD was significantly more frequent in public hospitals.

Conclusions:

• Medical factors like maternal characteristics and obstetric complications influence operative delivery choices.
• Significant disparities in CS and OVD rates exist between public and private hospitals in Greece.
• Socioeconomic factors and hospital setting appear to condition the use of operative delivery procedures.