Predictors of caesarean section in Northern Ghana: a case-control study

INTRODUCTION: Caesarean section rates have become a global public health. This study investigated obstetric and socio-demographic factors associated with caesarean section in northern Ghana. METHODS: This was a case-control study comparing 150 women who had caesarean section (cases) and 300 women who had vaginal delivery (controls). Data were collected retrospectively from delivery registers, postpartum and postnatal registers in the Bolgatanga Regional Hospital. Univariate and multivariate analysis of data were done using SPSS 22. RESULTS: The study revealed that women who had higher odds of having a caesarean section were women who; attended Antenatal care (ANC) ≥ 4 times (Adjusted OR= 2.99, 95% CI1.762-5.065), were referred from other health facilities (Adjusted OR = 1.19, 95% CI 1.108-1.337) and had a foetal weight of ≥ 4000 grams (Adjusted OR = 1.21, 95% CI 1.064-1.657). There was a slight increase in odds of having a caesarean section among women who had a gestational age > 40 weeks (Adjusted OR = 1.09, 95% CI 1.029-1.281). Women who had secondary/higher education (Adjusted OR = 0.55, 95% CI 0.320-0.941), gestational age < 37 weeks (Adjusted OR = 0.20, 95% CI: 0.100-0.412) and women who had a foetal weight of 1500 grams to 2499 grams (Adjusted OR = 0.17, 95% CI 0.086-0.339) were associated with a lower odds of having a caesarean section. CONCLUSION: There was an increase in odds of having a caesarean section among pregnant women who had a foetal weight of ≥ 4000 grams and women who attended ANC ≥ 4 times. Pregnant women who were referred also had increase odds of having a caesarean section.