Patterns of deliveries in a Brazilian birth cohort: almost universal cesarean sections for the better-off (original) (raw)
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Cesarean section on demand: a population-based study in Southern Brazil
Revista Brasileira de Saúde Materno Infantil
Objectives: to measure the prevalence and identify factors associated to the occurrence of cesarean section on demand in the municipality of Rio Grande, RS. Methods: all births that occurred in the two maternities between 01/01 to 12/31/2007, mothers who lived in the municipality were questioned on demographic and maternal reproductive characteristics, family socioeconomic level and health care received during pregnancy and childbirth. The outcome was constituted by cesarean section on demand, in other words, the request was from the parturient. In the analysis, Poisson regression was used with robust adjustment of the variance. The effect measurement used was the prevalence ratios (PR). Results: among the 2,557 parturients included in this study, 51.6% (CI95%:49.6%-53.5%) were submitted to cesarean sections, and 10.7% (CI95%:9.0%-12.4%) were on demand. After the adjustment based on previous hierarchical model, the variables showed significantly the association to the outcomes which...
Open Journal of Obstetrics and Gynecology, 2015
Introduction: There has been an increase in the proportion of cesarean deliveries, especially in developing countries. Methods: Cross-sectional study of all hospital live births from mothers living in São Paulo Metropolitan Area, Brazil. Data were obtained from the Live Birth Information System, which is linked to the National Database of Health Establishments. Hospitals were classified as public, private or mixed. Descriptive analysis and exponential regression were conducted to evaluate time trends. Poisson regression was applied to analyze each hospital type to identify risk factors and the attributable risk fraction for cesarean section. Results: There was an annual increase (1.4%) of cesarean deliveries between 2000 and 2013. In 2009, the percentage of cesarean deliveries was 53% overall and 83% in private hospitals. The primary risk factor for cesarean delivery was delivery in a private hospital. Other risk factors that were stronger in public hospitals included the following: advanced maternal age, high maternal education, nulliparity, high number of prenatal visits, multiple pregnancy, hospital with low annual volume of deliveries, birth outside the city of residence and white skin color. Discussion: These results may be explained by the obstetric care model of private hospitals, which is not multiprofessional. Prenatal care and delivery are conducted by the same doctor and rarely include the input of another professional, such as a midwife. In addition, the mode of delivery influences the professional's payment.
Trends and factors associated with cesarean sections in Brazil and its States between 2001 and 2015
O Mundo da Saúde, 2019
This study aimed to analyze the trends and socioeconomic factors associated with cesarean sections that occurred in Brazil and its states from 2001 to 2015. As hypotheses, it was suspected that there would be an increasing trend in the proportion of cesarean sections and an association with a higher socioeconomic status of women. This was an ecological and crosssectional study with data collected from the Live Birth Information System and the National Household Sample Survey. The proportions and trends of cesarean sections in relation to normal births were calculated for three years. The temporal trend was calculated by simple linear regression models and the correlation between the proportion of cesarean sections and socioeconomic factors were by the Spearman correlation coefficient, with a significance level of 5%. From the 2010-2012 triennium, all states had caesarean sections greater than 30%. The largest proportions of cesarean sections were observed in the last three years analyzed from 2013 to 2015; the lowest being 34.9% and the highest 66.8%. Between 2007 and 2015 in all states of the Midwest, Southeast and Southern Regions the amount exceeded 50%. All states showed a significant tendency for cesarean sections to increase over time. There was a positive and significant correlation between the number of cesarean sections and per capita income, households with garbage collection and the Human Development Index, and there was a negative correlation for the percentage of the population with incomes below half one minimum wage. The high rate of cesarean sections in Brazil indicates the need for specific interventions through public policies aimed at maternal and child health.
Revista Brasileira de Ginecologia e Obstetrícia / RBGO Gynecology and Obstetrics, 2020
Objective To obtain cesarean-section (CS) rates according to the Robson Group Classification in five different regions of Brazil. Methods A descriptive epidemiological study using data from secondary birth records from the Computer Science Department of the Brazilian Unified Health System (Datasus, in Portuguese) between January 1st, 2014, and December 31st, 2016, including all live births in Brazil. Results The overall rate of CS was of 56%. The sample was divided into 11 groups, and vaginal births were more frequent in groups 1 (53.6%), 3 (80.0%) and 4 (55.1%). The highest CS rates were found in groups 5 (85.7%), 6 (89.5%), 7 (85.2%) and 9 (97.0%). The overall CS rate per region varied from 46.2% in the North to 62.1% in the Midwest. Group 5 was the largest obstetric population in the South, Southeast and Midwest, and group 3 was the largest in the North and Northeast. Group 5 contributed the most to the overall CS rate, accounting for 30.8% of CSs. Conclusion Over half of the bir...
Brazilian regional differences and factors associated with the prevalence of cesarean sections
Fisioterapia em Movimento
Introduction: Brazil presents high C-section prevalence rates. Several factors may be associated with such high rates. Objective: To observe and analyze factors associated with the prevalence of cesarean sections in Brazil, according to their occurrence in Brazilian regions. Methods: An ecological study, having C-section as the outcome, from 1990 to 2013, in Brazilian regions, using data from the Brazilian National Health Survey, 2013. Records of women in their reproductive period, aged between 18 and 49 years, were included, totaling a sample of 16,175 women. Descriptive and bivariate analysis was carried out with logistic regression. Results: The prevalence of cesarean sections in Brazil was 53.03%. Vaginal delivery was more prevalent in the North (52.74%) and Northeast (51.06%) regions, while C-section was more prevalent in the Southeast (59.32%), South (56.96%) and Midwest (61.48%) regions. Over the years, an increased probability of cesarean sections was observed, particularly ...
abep.nepo.unicamp.br
Objectives We analized caesarean section in both public and private sectors; and maternal mortality associated with mode of delivery in the public sector (Sistema Unico de Saude -SUS) in Sao Paulo State, Brazil Methods We investigated 610,630 births in public and private sectors for 2003; and SUS 1,153,034 deliveries and 314 maternal deaths for 2001-2003. We estimated caesarean section rates and odds ratios for caesarean section in association with maternal characteristics in both public and private sectors; and SUS maternal mortality associated with mode of delivery, adjusted for hypertension, other disorders, problems and complications, as well as maternal age.
Birth in Brazil: national survey into labour and birth
Reproductive Health, 2012
Background: Caesarean section rates in Brazil have been steadily increasing. In 2009, for the first time, the number of children born by this type of procedure was greater than the number of vaginal births. Caesarean section is associated with a series of adverse effects on the women and newborn, and recent evidence suggests that the increasing rates of prematurity and low birth weight in Brazil are associated to the increasing rates of Caesarean section and labour induction.