OBJECTIVES: To evaluate caesarean section in both public and private sectors; maternal mortality associated with mode of delivery in the public sector (Sistema Unico de Saude, SUS) in Sao Paulo State, Brazil. STUDY DESIGN: 610,630 births in both public and private sectors for 2003; 1,153,034 deliveries and 314 maternal deaths in the public sector for 2001-2003. The study estimated caesarean section rates and odds ratios for caesarean section in association with maternal characteristics in both public and private sectors; maternal mortality associated with mode of delivery in the public sector, adjusted for hypertension, other disorders, problems and complications, as well as maternal age. RESULTS: The caesarean section rate was 32.9% in the public sector, and 80.4% in the private sector. The odd ratio for caesarean section was 2.6 (95% CI: 2.6-2.7) for women with 12 or more years of education. The odd ratio for maternal mortality associated with caesarean section in the public sector was 3.3 (95% CI: 2.6-4.3). CONCLUSIONS: Sao Paulo presented high caesarean section rates. Caesarean section compared to vaginal delivery in the public sector presented higher risk for mortality even when adjusted for hypertension, other disorders, problems and complications, as well as maternal age.
OBJECTIVES: To evaluate caesarean section in both public and private sectors; maternal mortality associated with mode of delivery in the public sector (Sistema Unico de Saude, SUS) in Sao Paulo State, Brazil. STUDY DESIGN: 610,630 births in both public and private sectors for 2003; 1,153,034 deliveries and 314 maternal deaths in the public sector for 2001-2003. The study estimated caesarean section rates and odds ratios for caesarean section in association with maternal characteristics in both public and private sectors; maternal mortality associated with mode of delivery in the public sector, adjusted for hypertension, other disorders, problems and complications, as well as maternal age. RESULTS: The caesarean section rate was 32.9% in the public sector, and 80.4% in the private sector. The odd ratio for caesarean section was 2.6 (95% CI: 2.6-2.7) for women with 12 or more years of education. The odd ratio for maternal mortality associated with caesarean section in the public sector was 3.3 (95% CI: 2.6-4.3). CONCLUSIONS: Sao Paulo presented high caesarean section rates. Caesarean section compared to vaginal delivery in the public sector presented higher risk for mortality even when adjusted for hypertension, other disorders, problems and complications, as well as maternal age.
Authors: Joseph A Spinnato; Salvio Freire; Joao Luiz Pinto e Silva; Marilza Vieira Cunha Rudge; Sérgio Martins-Costa; Matthew A Koch; Norman Goco; Cleide de Barros Santos; Jose Guilherme Cecatti; Roberto Costa; José Geraldo Ramos; Nancy Moss; Baha M Sibai Journal: Am J Obstet Gynecol Date: 2008-10 Impact factor: 8.661
Authors: Anna Seijmonsbergen-Schermers; Thomas van den Akker; Katrien Beeckman; Annick Bogaerts; Monalisa Barros; Patricia Janssen; Lorena Binfa; Eva Rydahl; Lucy Frith; Mechthild M Gross; Berglind Hálfdánsdóttir; Deirdre Daly; Jean Calleja-Agius; Patricia Gillen; Anne Britt Vika Nilsen; Eugene Declercq; Ank de Jonge Journal: BMJ Open Date: 2018-01-10 Impact factor: 2.692
Authors: A E Seijmonsbergen-Schermers; D C Zondag; M Nieuwenhuijze; T Van den Akker; C J Verhoeven; C Geerts; F Schellevis; A De Jonge Journal: BMC Pregnancy Childbirth Date: 2018-06-01 Impact factor: 3.007