Sherrie Kelly1, Ann Sprague1, Deshayne B Fell1, Phil Murphy2, Nancy Aelicks3, Yanfang Guo4, John Fahey5, Leeanne Lauzon5, Heather Scott6, Lily Lee7, Brooke Kinniburgh7, Monica Prince1, Mark Walker8. 1. Better Outcomes Registry & Network (BORN) Ontario, Ottawa ON; Children's Hospital of Eastern Ontario Research Institute, Ottawa ON. 2. Newfoundland and Labrador Provincial Perinatal Program, St. John's NL. 3. Alberta Perinatal Health Program, Edmonton AB. 4. Ottawa Hospital Research Institute, Ottawa ON. 5. Reproductive Care Program of Nova Scotia, Halifax NS. 6. Perinatal Services British Columbia, Vancouver BC. 7. Faculty of Medicine, University of Ottawa, Ottawa ON. 8. Better Outcomes Registry & Network (BORN) Ontario, Ottawa ON; Children's Hospital of Eastern Ontario Research Institute, Ottawa ON; Ottawa Hospital Research Institute, Ottawa ON; Faculty of Medicine, University of Ottawa, Ottawa ON.
Abstract
OBJECTIVE: To determine the groups within the obstetric population contributing most substantially to the Caesarean section rate in five Canadian provinces. METHODS: Hospital births from five participating provinces were grouped into Robson's 10 mutually exclusive and totally inclusive classification categories. The relative contribution of each group to the overall CS rate, relative size of group, and CS rate were calculated for British Columbia, Alberta, Ontario, Nova Scotia, and Newfoundland and Labrador for the four-year period from 2007-2008 to 2010-2011. RESULTS: In all five provinces (accounting for approximately 64% of births in Canada), and for all years examined, the group making the largest relative contribution to the CS rate was women with at least one previous CS and a term, singleton, cephalic-presenting pregnancy (Robson Group 5). The CS rate for this group ranged from 76.1% in Alberta to 89.9% in Newfoundland and Labrador in 2010 to 2011, accounting for 11.3% of all deliveries. The rate of CS for Group 5 decreased slightly over the four years, except in Ontario. The next largest contributing group was nulliparous women with a term, singleton, cephalic-presenting pregnancy. Those with induced labour or Caesarean section before labour (Robson Group 2) had CS rates ranging from 34.4% in Nova Scotia to 44.6% in British Columbia (accounting for 13.1% of all deliveries), and those with spontaneous onset of labour (Robson Group 1) had CS rates of 14.5% to 20.3% in 2010 to 2011 (accounting for 23.6% of all deliveries). CONCLUSION: All hospitals and health authorities can use this standardized classification system as part of a quality improvement initiative to monitor Caesarean section rates. This classification system identifies relevant areas for interventions and resources to reduce rates of Caesarean section.
OBJECTIVE: To determine the groups within the obstetric population contributing most substantially to the Caesarean section rate in five Canadian provinces. METHODS: Hospital births from five participating provinces were grouped into Robson's 10 mutually exclusive and totally inclusive classification categories. The relative contribution of each group to the overall CS rate, relative size of group, and CS rate were calculated for British Columbia, Alberta, Ontario, Nova Scotia, and Newfoundland and Labrador for the four-year period from 2007-2008 to 2010-2011. RESULTS: In all five provinces (accounting for approximately 64% of births in Canada), and for all years examined, the group making the largest relative contribution to the CS rate was women with at least one previous CS and a term, singleton, cephalic-presenting pregnancy (Robson Group 5). The CS rate for this group ranged from 76.1% in Alberta to 89.9% in Newfoundland and Labrador in 2010 to 2011, accounting for 11.3% of all deliveries. The rate of CS for Group 5 decreased slightly over the four years, except in Ontario. The next largest contributing group was nulliparous women with a term, singleton, cephalic-presenting pregnancy. Those with induced labour or Caesarean section before labour (Robson Group 2) had CS rates ranging from 34.4% in Nova Scotia to 44.6% in British Columbia (accounting for 13.1% of all deliveries), and those with spontaneous onset of labour (Robson Group 1) had CS rates of 14.5% to 20.3% in 2010 to 2011 (accounting for 23.6% of all deliveries). CONCLUSION: All hospitals and health authorities can use this standardized classification system as part of a quality improvement initiative to monitor Caesarean section rates. This classification system identifies relevant areas for interventions and resources to reduce rates of Caesarean section.
Authors: Marcos Nakamura-Pereira; Maria do Carmo Leal; Ana Paula Esteves-Pereira; Rosa Maria Soares Madeira Domingues; Jacqueline Alves Torres; Marcos Augusto Bastos Dias; Maria Elisabeth Moreira Journal: Reprod Health Date: 2016-10-17 Impact factor: 3.223
Authors: Ana Pilar Betrán; Nadia Vindevoghel; Joao Paulo Souza; A Metin Gülmezoglu; Maria Regina Torloni Journal: PLoS One Date: 2014-06-03 Impact factor: 3.240