Increases in Caesarean Delivery Rates and Change of Perinatal Outcomes in Low- and Middle-Income Countries: A Hospital-Level Analysis of Two WHO Surveys

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dc.contributor.author Zhao, Yanjun
dc.contributor.author Zhang, Jun
dc.contributor.author Zamora, Javier
dc.contributor.author Vogel, Joshua Peter
dc.contributor.author Souza, Joao P.
dc.contributor.author Jayaratne, Kapila
dc.contributor.author Ganchimeg, Togoobaatar
dc.contributor.author Ortiz-Panozo, Eduardo
dc.contributor.author Hernandez, Bernardo
dc.contributor.author Oladapo, Olufemi T.
dc.contributor.author Torloni, Maria R. [UNIFESP]
dc.contributor.author Morisaki, Naho
dc.contributor.author Mori, Rintaro
dc.contributor.author Pileggi-Castro, Cynthia
dc.contributor.author Tuncalp, Oezge
dc.contributor.author Shen, Xiaoming
dc.contributor.author Betran, Ana Pilar
dc.date.accessioned 2020-06-26T16:30:29Z
dc.date.available 2020-06-26T16:30:29Z
dc.date.issued 2017
dc.identifier http://dx.doi.org/10.1111/ppe.12363 ]
dc.identifier.citation Paediatric And Perinatal Epidemiology. Hoboken, v. 31, n. 4, p. 251-262, 2017.
dc.identifier.issn 0269-5022
dc.identifier.uri https://repositorio.unifesp.br/handle/11600/53575
dc.description.abstract Background: Maternal and neonatal outcomes have improved substantially. During the same period, the caesarean delivery rate soared. The aim of this analysis was to determine whether an increase in caesarean rate was associated with an improvement in perinatal outcome at an institutional level in low- and middle-income countries. Methods: The WHO Global Survey on Maternal and Perinatal Health (WHOGS) and the WHO Multi-Country Survey on Maternal and Newborn Health (WHOMCS) were two multi-country, facility-based, cross-sectional surveys conducted in 2004-08 and 2010-11, respectively. The increase in caesarean rate and the change of prevalence of adverse perinatal outcomes were calculated using a two-point estimator of percent change annualized (PCA) method. Maternal, perinatal, and neonatal composite indexes were used as the outcomes. A linear mixed model was used to assess the association between the change of caesarean rate and the change of perinatal outcome. Results: A total of 259 facilities in 20 countries participated in both surveys, with 217 844 women in WHOGS and 227 734 women in WHOMCS. The caesarean rate in these facilities increased, on average, by 4.0% annually, while the prevalence of adverse perinatal outcomes decreased by 4.6% annually. However, after adjustments for potential confounders, no association was found between the increase in caesarean rate and the change of adverse outcome indexes, regardless of whether starting caesarean rates were already high (above 10%) or not. Conclusions: In low- and middle-income countries, the increases in caesarean rates were not associated with improved perinatal outcomes regardless of whether the starting caesarean rate was already high or not. en
dc.description.sponsorship World Bank Special Programme of Research, Development and Research Training in Human Reproduction, Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland
dc.description.sponsorship National Natural Science Foundation of China
dc.format.extent 251-262
dc.language.iso eng
dc.publisher Wiley
dc.relation.ispartof Paediatric And Perinatal Epidemiology
dc.rights ACESSO RESTRITO
dc.subject caesarean delivery en
dc.subject perinatal en
dc.subject adverse outcomes en
dc.subject low and middle income countries en
dc.title Increases in Caesarean Delivery Rates and Change of Perinatal Outcomes in Low- and Middle-Income Countries: A Hospital-Level Analysis of Two WHO Surveys en
dc.type Artigo
dc.description.affiliation Shanghai Jiao Tong Univ, MOE Shanghai Key Lab Childrens Environm Hlth, Sch Med, Xinhua Hosp, Shanghai, Peoples R China
dc.description.affiliation Shanghai Jiao Tong Univ, Dept Child Hlth Care, Shanghai Childrens Hosp, Shanghai, Peoples R China
dc.description.affiliation Hosp Ramon & Cajal, CIBER Epidemiol & Publ Hlth, Clin Biostat Unit, Madrid, Spain
dc.description.affiliation Queen Mary Univ, Ctr Primary Care & Publ Hlth, Women Hlth Res Unit, London, England
dc.description.affiliation WHO, World Bank Special Programme Res Dev & Res Traini, Dept Reprod Hlth & Res, UNDP,UNFPA,UNICEF, Geneva, Switzerland
dc.description.affiliation Univ Sao Paulo, Dept Social Med, Ribeirao Preto Med Sch, Ribeirao Preto, SP, Brazil
dc.description.affiliation Minist Hlth, Family Hlth Bur, Colombo, Sri Lanka
dc.description.affiliation Univ Tsukuba, Fac Med, Tsukuba, Ibaraki, Japan
dc.description.affiliation Natl Inst Publ Hlth, Ctr Populat Hlth Res, Cuernavaca, Morelos, Mexico
dc.description.affiliation Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98195 USA
dc.description.affiliation Sao Paulo Fed Univ, Dept Med, Evidence Based Hlth Care Post Grad Program, Sao Paulo, Brazil
dc.description.affiliation Natl Ctr Child Hlth & Dev, Dept Social Med, Div Lifecourse Epidemiol, Tokyo, Japan
dc.description.affiliation Natl Ctr Child Hlth & Dev, Dept Hlth Policy, Tokyo, Japan
dc.description.affiliation Univ Sao Paulo, Ribeirao Preto Med Sch, Dept Pediat, Ribeirao Preto, SP, Brazil
dc.description.affiliationUnifesp Univ Fed Sao Paulo, Dept Med, Evidence Based Hlth Care Post Grad Program, Sao Paulo, Brazil
dc.description.sponsorshipID UNDP.UNFPA.UNICEF.WHO. World Bank Special Programme of Research, Development and Research Training in Human Reproduction, Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland
dc.description.sponsorshipID National Natural Science Foundation of China: 81273091
dc.identifier.doi 10.1111/ppe.12363
dc.description.source Web of Science
dc.identifier.wos WOS:000405827300001
dc.coverage Hoboken
dc.citation.volume 31 ]
dc.citation.issue 4 ]



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