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Can pre‐eclampsia explain higher cesarean rates in the different groups of Robson's classification?
Author(s) -
Sanchez Mariana P.,
Guida Jose P.,
Simões Marcela,
MarangoniJunior Marcos,
Cralcev Christopher,
Santos Juliana C.,
Dias Tabata Z.,
Luz Adriana G.,
Costa Maria L.
Publication year - 2021
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.13370
Subject(s) - medicine , eclampsia , confidence interval , referral , cesarean delivery , obstetrics , retrospective cohort study , pregnancy , gynecology , surgery , genetics , family medicine , biology
Objective To evaluate the impact of pre‐eclampsia on cesarean delivery by using the Robson classification. Methods A retrospective cross‐sectional study including all women who delivered in a referral maternity hospital in southeast Brazil from January 2017 to February 2018. Women were classified into 1 of 10 Robson groups and then further subdivided into pre‐eclampsia (PE) and non‐PE (NPE) groups. Frequency of cesarean was determined for each group and compared by using χ 2 and prevalence ratio. Results Overall, 3102 women were included, of whom 1578 (50.9%) delivered by cesarean. Classification in Robson group 5 was the most frequent among all women (n=727, 23.4%). In the PE group (n=258, 8.3%), group 10 was the most frequent classification (n=120, 46.5%); in NPE, Robson group 5 was the most frequency (n=682, 24.0%). Pre‐eclampsia was associated with a higher occurrence of cesarean (77.5% vs 48.4%; prevalence ratio, 2.29; 95% confidence interval, 1.82–2.82), owing to higher rates in Robson groups 1, 5, and 10. Conclusion Pre‐eclampsia was associated with a higher occurrence of cesarean delivery in some Robson groups. Robson classification may be used to evaluate the impact of specific conditions at a facility level to help plan future interventions to optimize the use of cesarean.