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Factors associated with cesarean delivery in public and private hospitals in a city of northeastern Brazil: a cross-sectional study

BACKGROUND: To evaluate the prevalence and factors associated with cesarean delivery according to whether care was provided in public or private hospitals in Brazil. METHODS: This was a cross-sectional study based on a cohort of live births between April 2004 and March 2005. A total of 1,344 mother-...

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Autores principales: Vieira, Graciete Oliveira, Fernandes, Lorena Gabriel, de Oliveira, Nelson Fernandes, Silva, Luciana Rodrigues, Vieira, Tatiana de Oliveira
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4457097/
https://www.ncbi.nlm.nih.gov/pubmed/26043857
http://dx.doi.org/10.1186/s12884-015-0570-8
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author Vieira, Graciete Oliveira
Fernandes, Lorena Gabriel
de Oliveira, Nelson Fernandes
Silva, Luciana Rodrigues
Vieira, Tatiana de Oliveira
author_facet Vieira, Graciete Oliveira
Fernandes, Lorena Gabriel
de Oliveira, Nelson Fernandes
Silva, Luciana Rodrigues
Vieira, Tatiana de Oliveira
author_sort Vieira, Graciete Oliveira
collection PubMed
description BACKGROUND: To evaluate the prevalence and factors associated with cesarean delivery according to whether care was provided in public or private hospitals in Brazil. METHODS: This was a cross-sectional study based on a cohort of live births between April 2004 and March 2005. A total of 1,344 mother-child pairs were followed up during the first month of life. The variables analyzed were the socioeconomic and demographic characteristics of the mother and newborn, as well as the healthcare provided during pregnancy and childbirth. Hierarchical analysis was carried out for both prediction models, i.e. healthcare provision either within the Brazilian National Health System (public service) or within the private network. Prevalence and association measurement calculations were carried out. Values were considered significant when pless than or equal to 5.0 %. RESULTS: A total of 1,019 (75,8 %) gave birth in public hospital. The prevalences of cesarean delivery were 29.9 % and 86.2 % in the public and private sectors, respectively. Through hierarchical logistic regression, the risk factors for cesarean delivery presented in the public hospital were maternal age greater than or equal to 20 years (p = 0.003), primiparity (p = 0.004), twinning (p = 0.039), prenatal care provided in the private network (p = 0.004), delivery in hospitals providing high complexity medical care (p = 0.000) and prenatal care with greater than or equal to 6 consultations (p = 0.035). In the private sector, no association was observed between the variables studied and cesarean delivery. CONCLUSIONS: The cesarean delivery rates were high in both sectors, although in the private network the rate was almost triple that of the public service. The absence of determinant factors of birth in the private sector drew attention. In planning measures against the growing cesarean rates, it is necessary to take into consideration the environmental determinants as primiparity, twinning and greater maternal age, frequent indications of primary cesarean delivery, as well as to implement actions that might improve the quality of prenatal and delivery care.
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spelling pubmed-44570972015-06-06 Factors associated with cesarean delivery in public and private hospitals in a city of northeastern Brazil: a cross-sectional study Vieira, Graciete Oliveira Fernandes, Lorena Gabriel de Oliveira, Nelson Fernandes Silva, Luciana Rodrigues Vieira, Tatiana de Oliveira BMC Pregnancy Childbirth Research Article BACKGROUND: To evaluate the prevalence and factors associated with cesarean delivery according to whether care was provided in public or private hospitals in Brazil. METHODS: This was a cross-sectional study based on a cohort of live births between April 2004 and March 2005. A total of 1,344 mother-child pairs were followed up during the first month of life. The variables analyzed were the socioeconomic and demographic characteristics of the mother and newborn, as well as the healthcare provided during pregnancy and childbirth. Hierarchical analysis was carried out for both prediction models, i.e. healthcare provision either within the Brazilian National Health System (public service) or within the private network. Prevalence and association measurement calculations were carried out. Values were considered significant when pless than or equal to 5.0 %. RESULTS: A total of 1,019 (75,8 %) gave birth in public hospital. The prevalences of cesarean delivery were 29.9 % and 86.2 % in the public and private sectors, respectively. Through hierarchical logistic regression, the risk factors for cesarean delivery presented in the public hospital were maternal age greater than or equal to 20 years (p = 0.003), primiparity (p = 0.004), twinning (p = 0.039), prenatal care provided in the private network (p = 0.004), delivery in hospitals providing high complexity medical care (p = 0.000) and prenatal care with greater than or equal to 6 consultations (p = 0.035). In the private sector, no association was observed between the variables studied and cesarean delivery. CONCLUSIONS: The cesarean delivery rates were high in both sectors, although in the private network the rate was almost triple that of the public service. The absence of determinant factors of birth in the private sector drew attention. In planning measures against the growing cesarean rates, it is necessary to take into consideration the environmental determinants as primiparity, twinning and greater maternal age, frequent indications of primary cesarean delivery, as well as to implement actions that might improve the quality of prenatal and delivery care. BioMed Central 2015-06-05 /pmc/articles/PMC4457097/ /pubmed/26043857 http://dx.doi.org/10.1186/s12884-015-0570-8 Text en © Vieira et al. 2015 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Vieira, Graciete Oliveira
Fernandes, Lorena Gabriel
de Oliveira, Nelson Fernandes
Silva, Luciana Rodrigues
Vieira, Tatiana de Oliveira
Factors associated with cesarean delivery in public and private hospitals in a city of northeastern Brazil: a cross-sectional study
title Factors associated with cesarean delivery in public and private hospitals in a city of northeastern Brazil: a cross-sectional study
title_full Factors associated with cesarean delivery in public and private hospitals in a city of northeastern Brazil: a cross-sectional study
title_fullStr Factors associated with cesarean delivery in public and private hospitals in a city of northeastern Brazil: a cross-sectional study
title_full_unstemmed Factors associated with cesarean delivery in public and private hospitals in a city of northeastern Brazil: a cross-sectional study
title_short Factors associated with cesarean delivery in public and private hospitals in a city of northeastern Brazil: a cross-sectional study
title_sort factors associated with cesarean delivery in public and private hospitals in a city of northeastern brazil: a cross-sectional study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4457097/
https://www.ncbi.nlm.nih.gov/pubmed/26043857
http://dx.doi.org/10.1186/s12884-015-0570-8
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