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Systematic review and meta‐analysis of studies on delivery preferences in Brazil
Author(s) -
Reiter Marilia,
Betrán Ana P.,
Marques Fernando K.,
Torloni Maria R.
Publication year - 2018
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1002/ijgo.12570
Subject(s) - cesarean delivery , medicine , confidence interval , preference , meta analysis , data extraction , cohort study , medline , pregnancy , demography , family medicine , obstetrics , statistics , genetics , mathematics , sociology , political science , law , biology
Background Cesarean delivery rates in Brazil are among the highest in the world. User preference is often mentioned as an important factor driving this. Objectives To identify, appraise, and synthesize the results of studies into delivery preferences in Brazil. Search strategy MEDLINE , LILACS , and Psyc INFO databases were searched, without language restrictions, using “delivery” and “preference” from inception to November 4, 2017. Selection criteria Cross‐sectional or cohort studies with quantitative data on delivery preferences of lay persons in Brazil. Data collection and analysis Two reviewers performed study selection, quality assessment, and data extraction. A meta‐analysis of proportions with a preference for cesarean delivery was performed, including subgroups analyses. Main results There were 28 studies with 31 071 participants included. The overall prevalence of preference for cesarean delivery was 27.2% (95% confidence interval [ CI ] 26.7%–27.7%; 28 studies, n=31 071). Cesarean delivery preference was higher among multiparas with previous cesarean deliveries (58.0%, 95% CI 56.6%–59.3%; nine studies, n=5542) than among multiparas without prior cesarean deliveries (17.3%, 95% CI 16.4%–18.2%; eight studies, n=7903), and among women with private health insurance (44.3%, 95% CI 43.0%–45.6%; nine studies, n=6048) than among those who depended on the public healthcare system (22.7%, 95% CI 22.2%–23.3%; 20 studies, n=24 314). Conclusions Overall, most lay persons in Brazil did not prefer to deliver by cesarean.