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Cesarean delivery in Iran: a population-based analysis using the Robson classification system
BACKGROUND: The rise of Cesarean Sections (CS) is a global concern. In Iran, the rate of CS increased from 40.7% in 2005 to 53% in 2014. This figure is even higher in the private sector. OBJECTIVE: To analyze the CS rates in the last 2 years using the Robson Classification System in Iran. METHODS: A...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8903666/ https://www.ncbi.nlm.nih.gov/pubmed/35260106 http://dx.doi.org/10.1186/s12884-022-04517-1 |
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author | Pourshirazi, Maryam Heidarzadeh, Mohammad Taheri, Mahshid Esmaily, Habibollah Babaey, Farah Talkhi, Nasrin Gholizadeh, Leila |
author_facet | Pourshirazi, Maryam Heidarzadeh, Mohammad Taheri, Mahshid Esmaily, Habibollah Babaey, Farah Talkhi, Nasrin Gholizadeh, Leila |
author_sort | Pourshirazi, Maryam |
collection | PubMed |
description | BACKGROUND: The rise of Cesarean Sections (CS) is a global concern. In Iran, the rate of CS increased from 40.7% in 2005 to 53% in 2014. This figure is even higher in the private sector. OBJECTIVE: To analyze the CS rates in the last 2 years using the Robson Classification System in Iran. METHODS: A retrospective analysis of all in-hospital electronically recorded deliveries in Iran was conducted using the Robson classification. Comparisons were made in terms of the type of hospital, CS rate, and obstetric population, and contributions of each group to the overall cesarean deliveries were reported. RESULTS: Two million three hundred twenty-two thousand five hundred women gave birth, 53.6% delivered through CS. Robson group 5 was the largest contributing group to the overall number of cesarean deliveries (47.1%) at a CS rate of 98.4%. Group 2 and 1 ranked the second and third largest contributing groups to overall CSs (20.6 and 10.8%, respectively). The latter groups had CS rates much higher than the WHO recommendation of 67.2 and 33.1%, respectively. “Fetal Distress” and “Undefined Indications” were the most common reasons for cesarean deliveries at CS rates of 13.6 and 13.4%, respectively. There was a significant variation in CS rate among the three types of hospitals for Robson groups 1, 2, 3, 4, and 10. CONCLUSION: The study revealed significant variations in CS rate by hospital peer-group, especially for the private maternity units, suggesting the need for further attention and audit of the Robson groups that significantly influence the overall CS rate. The study results will help policymakers identify effective strategies to reduce the CS rate in Iran, providing appropriate benchmarking to compare obstetric care with other countries that have better maternal and perinatal outcomes. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12884-022-04517-1. |
format | Online Article Text |
id | pubmed-8903666 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-89036662022-03-18 Cesarean delivery in Iran: a population-based analysis using the Robson classification system Pourshirazi, Maryam Heidarzadeh, Mohammad Taheri, Mahshid Esmaily, Habibollah Babaey, Farah Talkhi, Nasrin Gholizadeh, Leila BMC Pregnancy Childbirth Research BACKGROUND: The rise of Cesarean Sections (CS) is a global concern. In Iran, the rate of CS increased from 40.7% in 2005 to 53% in 2014. This figure is even higher in the private sector. OBJECTIVE: To analyze the CS rates in the last 2 years using the Robson Classification System in Iran. METHODS: A retrospective analysis of all in-hospital electronically recorded deliveries in Iran was conducted using the Robson classification. Comparisons were made in terms of the type of hospital, CS rate, and obstetric population, and contributions of each group to the overall cesarean deliveries were reported. RESULTS: Two million three hundred twenty-two thousand five hundred women gave birth, 53.6% delivered through CS. Robson group 5 was the largest contributing group to the overall number of cesarean deliveries (47.1%) at a CS rate of 98.4%. Group 2 and 1 ranked the second and third largest contributing groups to overall CSs (20.6 and 10.8%, respectively). The latter groups had CS rates much higher than the WHO recommendation of 67.2 and 33.1%, respectively. “Fetal Distress” and “Undefined Indications” were the most common reasons for cesarean deliveries at CS rates of 13.6 and 13.4%, respectively. There was a significant variation in CS rate among the three types of hospitals for Robson groups 1, 2, 3, 4, and 10. CONCLUSION: The study revealed significant variations in CS rate by hospital peer-group, especially for the private maternity units, suggesting the need for further attention and audit of the Robson groups that significantly influence the overall CS rate. The study results will help policymakers identify effective strategies to reduce the CS rate in Iran, providing appropriate benchmarking to compare obstetric care with other countries that have better maternal and perinatal outcomes. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12884-022-04517-1. BioMed Central 2022-03-08 /pmc/articles/PMC8903666/ /pubmed/35260106 http://dx.doi.org/10.1186/s12884-022-04517-1 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Pourshirazi, Maryam Heidarzadeh, Mohammad Taheri, Mahshid Esmaily, Habibollah Babaey, Farah Talkhi, Nasrin Gholizadeh, Leila Cesarean delivery in Iran: a population-based analysis using the Robson classification system |
title | Cesarean delivery in Iran: a population-based analysis using the Robson classification system |
title_full | Cesarean delivery in Iran: a population-based analysis using the Robson classification system |
title_fullStr | Cesarean delivery in Iran: a population-based analysis using the Robson classification system |
title_full_unstemmed | Cesarean delivery in Iran: a population-based analysis using the Robson classification system |
title_short | Cesarean delivery in Iran: a population-based analysis using the Robson classification system |
title_sort | cesarean delivery in iran: a population-based analysis using the robson classification system |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8903666/ https://www.ncbi.nlm.nih.gov/pubmed/35260106 http://dx.doi.org/10.1186/s12884-022-04517-1 |
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