The Increasing Trend in Caesarean Section Rates: Global, Regional and National Estimates: 1990-2014

The Increasing Trend in Caesarean Section Rates: Global, Regional and National Estimates: 1990-2014

Author Betran, Ana Pilar Google Scholar
Ye, Jianfeng Google Scholar
Moller, Anne-Beth Google Scholar
Zhang, Jun Google Scholar
Guelmezoglu, A. Metin Google Scholar
Torloni, Maria Regina Autor UNIFESP Google Scholar
Abstract Background Caesarean section (CS) rates continue to evoke worldwide concern because of their steady increase, lack of consensus on the appropriate CS rate and the associated additional short-and long-term risks and costs. We present the latest CS rates and trends over the last 24 years. Methods We collected nationally-representative data on CS rates between 1990 to 2014 and calculated regional and subregional weighted averages. We conducted a longitudinal analysis calculating differences in CS rates as absolute change and as the average annual rate of increase (AARI). Results According to the latest data from 150 countries, currently 18.6% of all births occur by CS, ranging from 6% to 27.2% in the least and most developed regions, respectively. Latin America and the Caribbean region has the highest CS rates (40.5%), followed by Northern America (32.3%), Oceania (31.1%), Europe (25%), Asia (19.2%) and Africa (7.3%). Based on the data from 121 countries, the trend analysis showed that between 1990 and 2014, the global average CS rate increased 12.4% (from 6.7% to 19.1%) with an average annual rate of increase of 4.4%. The largest absolute increases occurred in Latin America and the Caribbean (19.4%, from 22.8% to 42.2%), followed by Asia (15.1%, from 4.4% to 19.5%), Oceania (14.1%, from 18.5% to 32.6%), Europe (13.8%, from 11.2% to 25%), Northern America (10%, from 22.3% to 32.3%) and Africa (4.5%, from 2.9% to 7.4%). Asia and Northern America were the regions with the highest and lowest average annual rate of increase (6.4% and 1.6%, respectively). Conclusion The use of CS worldwide has increased to unprecedented levels although the gap between higher- and lower-resource settings remains. The information presented is essential to inform policy and global and regional strategies aimed at optimizing the use of CS.
xmlui.dri2xhtml.METS-1.0.item-coverage San Francisco
Language English
Sponsor World Health Organization
Grant number World Health Organization: 001
Date 2016
Published in Plos One. San Francisco, v. 11, n. 2, p. -, 2016.
ISSN 1932-6203 (Sherpa/Romeo, impact factor)
Publisher Public Library Science
Extent -
Origin http://dx.doi.org/10.1371/journal.pone.0148343
Access rights Open access Open Access
Type Article
Web of Science ID WOS:000369554000073
URI https://repositorio.unifesp.br/handle/11600/57983

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