Marcos Nakamura-Pereira1,2, Ana Paula Esteves-Pereira2, Silvana G N Gama2, Maria Leal2. 1. Fernandes Figueira National Institute for Women's, Children's and Adolescents' Health, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil. 2. Department of Epidemiology and Quantitative Methods in Health, Sérgio Arouca National School of Public Health, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil.
Abstract
OBJECTIVE: To assess the hospital, maternal, and obstetric characteristics associated with elective repeat cesarean delivery (ERCD) among women eligible for trial of labor after cesarean (TOLAC) delivery in Brazil. METHODS: The present data were retrieved from the Birth in Brazil study, a national hospital-based cohort study conducted during 2011-2012. Data were collected from medical records and by interview. Univariate and hierarchical multiple logistic regression analyses were performed to analyze factors associated with ERCD among women with a previous cesarean delivery who were eligible for TOLAC. RESULTS: Among 2295 women considered eligible for TOLAC, 1516 (66.1%) had an ERCD; the overall cesarean delivery rate was 79.4%. In the private sector, almost all deliveries (95.3%) were performed by ERCD. In the public sector, ERCD was associated with socioeconomic (more years of schooling), obstetric (women's preference, no previous vaginal delivery, macrosomia), and hospital (mixed hospital, location in noncapital city, fewer than 1500 deliveries per year) characteristics. CONCLUSION: The ERCD rate in Brazil was high even in a low-risk group, indicating that nonclinical factors may be driving the decision for cesarean delivery. Efforts aiming to reduce cesarean deliveries in Brazil should target women with a previous cesarean delivery.
OBJECTIVE: To assess the hospital, maternal, and obstetric characteristics associated with elective repeat cesarean delivery (ERCD) among women eligible for trial of labor after cesarean (TOLAC) delivery in Brazil. METHODS: The present data were retrieved from the Birth in Brazil study, a national hospital-based cohort study conducted during 2011-2012. Data were collected from medical records and by interview. Univariate and hierarchical multiple logistic regression analyses were performed to analyze factors associated with ERCD among women with a previous cesarean delivery who were eligible for TOLAC. RESULTS: Among 2295 women considered eligible for TOLAC, 1516 (66.1%) had an ERCD; the overall cesarean delivery rate was 79.4%. In the private sector, almost all deliveries (95.3%) were performed by ERCD. In the public sector, ERCD was associated with socioeconomic (more years of schooling), obstetric (women's preference, no previous vaginal delivery, macrosomia), and hospital (mixed hospital, location in noncapital city, fewer than 1500 deliveries per year) characteristics. CONCLUSION: The ERCD rate in Brazil was high even in a low-risk group, indicating that nonclinical factors may be driving the decision for cesarean delivery. Efforts aiming to reduce cesarean deliveries in Brazil should target women with a previous cesarean delivery.
Authors: Kartik K Venkatesh; Suzanne Brodney; Michael J Barry; Jamie Jackson; Kiira M Lyons; Asha N Talati; Thomas S Ivester; Maria C Munoz; John M Thorp; Wanda K Nicholson Journal: BMC Pregnancy Childbirth Date: 2021-09-23 Impact factor: 3.007
Authors: Enny S Paixao; Christian Bottomley; Liam Smeeth; Maria Conceicao N da Costa; Maria Gloria Teixeira; Maria Yury Ichihara; Ligia Gabrielli; Mauricio L Barreto; Oona M R Campbell Journal: BMC Pregnancy Childbirth Date: 2021-08-30 Impact factor: 3.007
Authors: Barbara Almeida Soares Dias; Maria do Carmo Leal; Katrini Guidolini Martinelli; Marcos Nakamura-Pereira; Ana Paula Esteves-Pereira; Edson Theodoro Dos Santos Neto Journal: Rev Saude Publica Date: 2022-03-11 Impact factor: 2.106