Social and helth determinants in the occurence of cesarean delivery
DOI:
https://doi.org/10.33448/rsd-v12i8.42958Keywords:
Obstetric Delivery; Cesarean section; Cross-sectional Studies; Primary Health Care; Pregnant women.Abstract
Objective: To assess the effect of social and maternal health characteristics on the prevalence of cesarean delivery. Methods: Population-based study with pregnant women aged 18 years or older, registered and monitored by the public health service, in the urban area. Demographic, socioeconomic, health history, and obstetric characteristics were collected using previously tested and standardized questionnaires. Prevalence Ratios (PR) were calculated in the bivariate analysis and odds ratios (OR) adjusted by logistic regression according to a hierarchical model. Results: The prevalence of cesarean sections was 63.74%. After adjustments, age greater than or equal to 35 years (OR = 2.15; 95%CI 1.22 - 3.79), having a partner (OR = 1.56; 95%CI 1.02 - 2. 37), overweight/obesity (OR = 1.57; 95%CI 1.13 – 2.17) having prenatal care (OR = 1.65; 95%CI 1.17 – 2.32) and presenting different characteristics in the pregnancy, such as breech or transverse fetal presentation and type of multiple pregnancy (OR = 3.98; 95%CI 1.54 – 10.31). Conclusion: It was found that the prevalence of cesarean section is above acceptable levels and that clinical factors and social determinants are associated with this practice. Thus, greater political attention to social and health conditions during pregnancy and childbirth is necessary.
References
Akinyemi, O. A., Tanna, R., Adetokunbo, S., Omokhodion, O., Fasokun, M., Akingbule, A. S., Martins, C., Fakorede, M., Ogundipe, T., & Filani, O. (2022). Increasing Pre-pregnancy Body Mass Index and Pregnancy Outcomes in the United States. Cureus, 14(9), e28695. https://doi.org/10.7759/cureus.28695
Barros, A. J., Santos, I. S., Matijasevich, A., Domingues, M. R., Silveira, M., Barros, F. C., & Victora, C. G. (2011). Patterns of deliveries in a Brazilian birth cohort: Almost universal cesarean sections for the better-off. Revista de Saúde Pública, 45(4), 635–643. https://doi.org/10.1590/s0034-89102011005000039
Betrn, A. P., Gulmezoglu, A. M., Robson, M., Merialdi, M., Souza, J. P., Wojdyla, D., Widmer, M., Carroli, G., Torloni, M. R., Langer, A., Narvez, A., Velasco, A., Fandes, A., Acosta, A., Valladares, E., Romero, M., Zavaleta, N., Reynoso, S., & Bataglia, V. (2009). WHO global survey on maternal and perinatal health in Latin America: Classifying caesarean sections. Reproductive Health, 6(1), 4-11. https://doi.org/10.1186/1742-4755-6-18
Brasil. (2017). Ministério da Saúde. Departamento de Informática do SUS (DATASUS). Sistema de Informações sobre Nascidos Vivos (SINASC). In: http://tabnet.datasus.gov.br/cgi/tabcgi.exe?sinasc/cnv/nvbr.def
Briese, V., Voigt, M., Wisser, J., Borchardt, U., & Straube, S. (2011). Risks of pregnancy and birth in obese primiparous women: An analysis of German perinatal statistics. Archives of Gynecology and Obstetrics, 283(2), 249–253. https://doi.org/10.1007/s00404-009-1349-9
Carmo Leal, M., Gama, S. G. N., Pereira, A. P. E., Pacheco, V. E., Carmo, C. N., & Santos, R. V. (2017). A cor da dor: Iniquidades raciais na atenção pré-natal e ao parto no Brasil. Cadernos de Saúde Pública, 33(SUPPL1), e00078816. https://doi.org/10.1590/0102-311X00078816
Carmo Leal, M., Pereira, A. P. E., Domingues, R. M. S. M., Filha, M. M. T., Dias, M. A. B., Nakamura-Pereira, M., Bastos, M. H., & Gama, S. G. N. (2014). Intervenções obstétricas durante o trabalho de parto e parto em mulheres Brasileiras de risco habitual. Cadernos de Saúde Pública, 30(SUPPL1), S17-S32. https://doi.org/10.1590/0102-311X00151513
Conceição, E. R. (2010). A influência do peso materno sobre a via de parto (Dissertação de mestrado). Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Pós-Graduação em Tocoginecologia. Campinas.
Dias, M. A. B., Domingues, R. M. S. M., Pereira, A. P. E., Fonseca, S. C., Gama, S. G. N., Theme Filha, M. M., ... Carmo Leal, M. (2008). Avaliação da demanda por cesariana e da adequação de sua indicação em unidades hospitalares do Sistema de Saúde Suplementar do Rio de Janeiro, In: Zouain, C. S., & Torres, J. A. (Orgs.). O Modelo de Atenção Obstétrica no Setor de Saúde Suplementar no Brasil: cenários e perspectivas. (pp. 95-126). Rio de Janeiro, BR: Agência Nacional de Saúde Suplementar.
Domingues, R. M. S. M., Dias, M. A. B., Nakamura-Pereira, M., Torres, J. A., d'Orsi, E., Pereira, A. P. E., Schilithz, A. O. C., & Leal, M. C. (2014). Processo de decisão pelo tipo de parto no Brasil: da preferência inicial das mulheres à via de parto final. Cadernos de Saúde Pública, 30(SUPPL1), S101–S116. https://doi.org/10.1590/0102-311X00105113
Freitas, P. F., & Fernandes, T. M. B. (2016). Associação entre fatores institucionais, perfil da assistência ao parto e as taxas de cesariana em Santa Catarina. Revista Brasileira de Epidemiologia, 19(3), 525–538. https://doi.org/10.1590/1980-5497201600030005
Gama, S. G. N., Viellas, E. F., Schilithz, A. O. C., Filha, M. M. T., Carvalho, M. L., Gomes, K. R. O., Costa, M. C. O., & Leal, M. C. (2014). Fatores associados à cesariana entre primíparas adolescentes no Brasil, 2011-2012. Cadernos de Saúde Pública, 30(SUPPL1), S117–S127. https://doi.org/10.1590/0102-311X00145513
Gutema, H. (2014). Caesarean Section and Associated Factors at Mizan Aman General Hospital Southwest Ethiopia. Journal of Gynecology and Obstetrics, 2(3), 37. https://doi.org/10.11648/j.jgo.20140203.12
Hamilton, E. L., McLaughlin, K., & Mollart, L. (2023). Factors that Influence Women's Decision on the Mode of Birth After a Previous Caesarean Section: A Meta-ethnography. International journal of community based nursing and midwifery, 11(3), 152–168. https://doi.org/10.30476/IJCBNM.2023.97229.2171
Herstad, L., Klungsøyr, K., Skjærven, R., Tanbo, T., Eidem, I., Forsén, L., Åbyholm, T., & Vangen, S. (2012). Maternal age and elective cesarean section in a low-risk population. Acta Obstetricia et Gynecologica Scandinavica, 91(7), 816–823. https://doi.org/10.1111/j.1600-0412.2012.01405.x
Institute of Medicine. (2009). Weight gain during pregnancy: reexamining the guidelines. Rasmussen KM, Yaktine AL (eds). Committee to Reexamine IOM Pregnancy Weight Guidelines: Institute of Medicine USA: National Research Council. Washington (DC).
Instituto Brasileiro de Geografia e Estatística - IBGE (2010). Censo Demográfico 2010. In: http://www.censo2010.ibge.gov.br
Jelliffe, D. B. (1968). Evaluación del estado de nutrición de la comunidade. Série de monografias. (pp. 291). Geneva: Organización Mundial de la Salud.
Leite, F. M. C., Barbosa, T. K. O., Bravim, L. R., Amorim, M. H. C., & Primo, C. C. (2014). A influência das características socioeconômicas no perfil obstétrico de puérperas. Aquichan, 14(4), 571-581. https://doi.org/10.5294/aqui.2014.14.4.11
Ludford, I., Scheil, W., Tucker, G., & Grivell, R. (2012). Pregnancy outcomes for nulliparous women of advanced maternal age in South Australia, 1998-2008. The Australian & New Zealand Journal of Obstetrics & Gynaecology, 52(3), 235–241. https://doi.org/10.1111/j.1479-828X.2012.01442.x
Madeiro, A., Rufino, A. C., & Santos, A. O. (2017). Partos cesáreos no Piauí: tendência e fatores associados no período 2000-2011. Epidemiologia e Serviços de Saúde, 26(1), 81–90. https://doi.org/10.5123/S1679-49742017000100009
Meller, F. O., & Schäfer, A. A. (2011). Fatores associados ao tipo de parto em mulheres brasileiras: PNDS 2006. Ciência & Saúde Coletiva, 16(9), 3829–3835. https://doi.org/10.1590/S1413-81232011001000018
Nakamura-Pereira, M., Carmo Leal, M., Esteves-Pereira, A. P., Domingues, R. M., Torres, J. A., Dias, M. A., & Moreira, M. E. (2016). Use of Robson classification to assess cesarean section rate in Brazil: The role of source of payment for childbirth. Reproductive health, 13(Suppl 3), 128. https://doi.org/10.1186/s12978-016-0228-7
Oliveira, D. R., & Cruz, M. K. P. (2010). Estudo das indicações de parto cesáreo em primigestas no município de Barbalha-Ceará. Rev Rene, 11(3), 114-121. https://doi.org/10.15253/2175-6783.20100003000012
Organização Mundial de Saúde - OMS. (2015). Declaração da OMS sobre Taxas de Cesáreas. In: https://apps.who.int/iris/bitstream/handle/10665/161442/WHO_RHR_15.02_por.pdf
Pádua, K. S., Osis, M. J. D., Faúndes, A., Barbosa, A. H., & Filho, O. B. M. (2010). Factors associated with cesarean sections in Brazilian hospitals. Revista de Saúde Pública, 44(1), 70-79. https://doi.org/10.1590/s0034-89102010000100008
Pevzner, L., Powers, B. L., Rayburn, W. F., Rumney, P., & Wing, D. A. (2009). Effects of maternal obesity on duration and outcomes of prostaglandin cervical ripening and labor induction. Obstetrics and Gynecology, 114(6), 1315–1321. https://doi.org/10.1097/AOG.0b013e3181bfb39f
Poobalan, A. S., Aucott, L. S., Gurung, T., Smith, W. C., & Bhattacharya, S. (2009). Obesity as an independent risk factor for elective and emergency caesarean delivery in nulliparous women--systematic review and meta-analysis of cohort studies. Obesity Reviews, 10(1), 28–35. https://doi.org/10.1111/j.1467-789X.2008.00537.x
Rattner, D., & Moura, E. C. (2016). Nascimentos no Brasil: Associação do tipo de parto com variáveis temporais e sociodemográficas. Revista Brasileira de Saúde Materno Infantil, 16(1), 39–47. https://doi.org/10.1590/1806-93042016000100005
Rosendo, T. M. S. S., & Roncalli, A. G. (2015). Prevalence and factors associated with Maternal Near Misses: A survey of the population in a capital city of the Brazilian Northeast. Ciência & Saúde Coletiva, 20(4), 1295–1304. https://doi.org/10.1590/1413-81232015204.09052014
Rydahl, E., Declercq, E., Juhl, M., & Maimburg, R. D. (2019). Cesarean section on a rise-Does advanced maternal age explain the increase? A population register-based study. PloS One, 14(1), e0210655. https://doi.org/10.1371/journal.pone.0210655
Seligman, L. C., Duncan, B. B., Branchtein, L., Gaio, D. S., Mengue, S. S., & Schmidt, M. I. (2006). Obesity and gestational weight gain: cesarean delivery and labor complications. Revista de Saúde Pública, 40(3), 457–465. https://doi.org/10.1590/s0034-89102006000300014
Silva, T. P. R. da ., Dumont-Pena, E., Moreira, A. D., Camargos, B. A., Meireles, M. Q., Souza, K. V. de ., & Matozinhos, F. P.. (2020). Factors associated with normal and cesarean delivery in public and private maternity hospitals: a cross-sectional study. Revista Brasileira De Enfermagem, 73, e20180996. https://doi.org/10.1590/0034-7167-2018-0996
Tsega, F., Mengistie, B., Dessie, Y., & Mengesha, M. M. (2015). Prevalence of Cesarean Section in Urban Health Facilities and Associated Factors in Eastern Ethiopia: Hospital Based Cross Sectional Study. Journal of Pregnancy and Child Health, 2(3), 169. https://doi.org/10.4172/2376-127x.1000169
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2023 Janaina Vasconcelos Rocha; Manuela Alves dos Santos; Alana Cristiny Miranda Soares; Cristiane dos Santos Silva; Edna Maria de Araújo; Rosa Cândida Cordeiro; Djanilson Barbosa dos Santos
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
1) Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
2) Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
3) Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.