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A comparison of trends in cesarean delivery in Paraguay between 1995 and 2008
Author(s) -
Yuen Jiasong,
Painter Ian,
Abraham Linta,
Melian Mercedes,
Denno Donna M.
Publication year - 2014
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 - 10.1016/j.ijgo.2014.03.030
Subject(s) - medicine , cesarean delivery , odds ratio , logistic regression , confidence interval , obstetrics , retrospective cohort study , pregnancy , gynecology , surgery , genetics , pathology , biology
Objective To identify maternal factors associated with the rise in the cesarean delivery rate in Paraguay. Methods Retrospective analysis of the 1995 and the 2008 National Survey on Demographic and Sexual and Reproductive Health data using multivariable logistic regression. Results In 2008, 1094 (37.3%) deliveries were cesarean compared with 781 (19.3%) in 1995. Home births had decreased by 72.9%, accounting for 33.3% of the change in the proportion of cesarean deliveries. Private facilities were associated with an increased odds ratio of cesarean delivery of 2.60 (95% confidence interval [CI], 2.02–3.34) and 4.89 (95% CI, 3.67–6.51) in 1995 and 2008, respectively, and accounted for 32.8% of the increase in cesarean deliveries between 1995 and 2008. Cesarean delivery was also associated with a prior cesarean, insurance status, and maternal higher educational and economic status. Conclusion Between 1995 and 2008 the cesarean delivery rate in Paraguay almost doubled. More than one‐third of deliveries were cesarean. Shifts toward facility‐ (particularly private) based deliveries and repeat cesarean for women with a previous cesarean influenced this increase. Practice guidelines, regulation, and oversight of facilities, along with education and information for pregnant women, are needed to curb unnecessary and potentially harmful surgical delivery interventions.