Cesarean delivery in Iran: a population-based analysis using the Robson classification system.

Pourshirazi, M; Heidarzadeh, M; Taheri, M; Esmaily, H; Babaey, F; Talkhi, N; Gholizadeh, L

Cesarean delivery in Iran: a population-based analysis using the Robson classification system.

Pourshirazi, M Heidarzadeh, M Taheri, M Esmaily, H Babaey, F Talkhi, N Gholizadeh, L

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Publisher:: BMC
Publication Type:: Journal Article
Citation:: BMC Pregnancy Childbirth, 2022, 22, (1), pp. 185
Issue Date:: 2022-03-08

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Field	Value	Language
dc.contributor.author	Pourshirazi, M
dc.contributor.author	Heidarzadeh, M
dc.contributor.author	Taheri, M
dc.contributor.author	Esmaily, H
dc.contributor.author	Babaey, F
dc.contributor.author	Talkhi, N
dc.contributor.author	Gholizadeh, L https://orcid.org/0000-0002-6711-3312
dc.date.accessioned	2022-04-03T23:17:23Z
dc.date.available	2022-02-25
dc.date.available	2022-04-03T23:17:23Z
dc.date.issued	2022-03-08
dc.identifier.citation	BMC Pregnancy Childbirth, 2022, 22, (1), pp. 185
dc.identifier.issn	1471-2393
dc.identifier.issn	1471-2393
dc.identifier.uri	http://hdl.handle.net/10453/155908
dc.description.abstract	BACKGROUND: The rise of Cesarean Sections (CS) is a global concern. In Iran, the rate of CS increased from 40.7% in 2005 to 53% in 2014. This figure is even higher in the private sector. OBJECTIVE: To analyze the CS rates in the last 2 years using the Robson Classification System in Iran. METHODS: A retrospective analysis of all in-hospital electronically recorded deliveries in Iran was conducted using the Robson classification. Comparisons were made in terms of the type of hospital, CS rate, and obstetric population, and contributions of each group to the overall cesarean deliveries were reported. RESULTS: Two million three hundred twenty-two thousand five hundred women gave birth, 53.6% delivered through CS. Robson group 5 was the largest contributing group to the overall number of cesarean deliveries (47.1%) at a CS rate of 98.4%. Group 2 and 1 ranked the second and third largest contributing groups to overall CSs (20.6 and 10.8%, respectively). The latter groups had CS rates much higher than the WHO recommendation of 67.2 and 33.1%, respectively. "Fetal Distress" and "Undefined Indications" were the most common reasons for cesarean deliveries at CS rates of 13.6 and 13.4%, respectively. There was a significant variation in CS rate among the three types of hospitals for Robson groups 1, 2, 3, 4, and 10. CONCLUSION: The study revealed significant variations in CS rate by hospital peer-group, especially for the private maternity units, suggesting the need for further attention and audit of the Robson groups that significantly influence the overall CS rate. The study results will help policymakers identify effective strategies to reduce the CS rate in Iran, providing appropriate benchmarking to compare obstetric care with other countries that have better maternal and perinatal outcomes.
dc.format	Electronic
dc.language	eng
dc.publisher	BMC
dc.relation.ispartof	BMC Pregnancy Childbirth
dc.relation.isbasedon	10.1186/s12884-022-04517-1
dc.rights	info:eu-repo/semantics/openAccess
dc.subject	1110 Nursing, 1114 Paediatrics and Reproductive Medicine, 1117 Public Health and Health Services
dc.subject.classification	Obstetrics & Reproductive Medicine
dc.subject.mesh	Humans
dc.subject.mesh	Cesarean Section
dc.subject.mesh	Population Surveillance
dc.subject.mesh	Registries
dc.subject.mesh	Retrospective Studies
dc.subject.mesh	Pregnancy
dc.subject.mesh	Adolescent
dc.subject.mesh	Adult
dc.subject.mesh	Hospitals, Private
dc.subject.mesh	Hospitals, Public
dc.subject.mesh	Iran
dc.subject.mesh	Female
dc.subject.mesh	Young Adult
dc.title	Cesarean delivery in Iran: a population-based analysis using the Robson classification system.
dc.type	Journal Article
utslib.citation.volume	22
utslib.location.activity	England
utslib.for	1110 Nursing
utslib.for	1114 Paediatrics and Reproductive Medicine
utslib.for	1117 Public Health and Health Services
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Strength - CHSP - Health Services and Practice
utslib.copyright.status	open_access	*
dc.date.updated	2022-04-03T23:17:21Z
pubs.issue	1
pubs.publication-status	Published online
pubs.volume	22
utslib.citation.issue	1

Abstract:

BACKGROUND: The rise of Cesarean Sections (CS) is a global concern. In Iran, the rate of CS increased from 40.7% in 2005 to 53% in 2014. This figure is even higher in the private sector. OBJECTIVE: To analyze the CS rates in the last 2 years using the Robson Classification System in Iran. METHODS: A retrospective analysis of all in-hospital electronically recorded deliveries in Iran was conducted using the Robson classification. Comparisons were made in terms of the type of hospital, CS rate, and obstetric population, and contributions of each group to the overall cesarean deliveries were reported. RESULTS: Two million three hundred twenty-two thousand five hundred women gave birth, 53.6% delivered through CS. Robson group 5 was the largest contributing group to the overall number of cesarean deliveries (47.1%) at a CS rate of 98.4%. Group 2 and 1 ranked the second and third largest contributing groups to overall CSs (20.6 and 10.8%, respectively). The latter groups had CS rates much higher than the WHO recommendation of 67.2 and 33.1%, respectively. "Fetal Distress" and "Undefined Indications" were the most common reasons for cesarean deliveries at CS rates of 13.6 and 13.4%, respectively. There was a significant variation in CS rate among the three types of hospitals for Robson groups 1, 2, 3, 4, and 10. CONCLUSION: The study revealed significant variations in CS rate by hospital peer-group, especially for the private maternity units, suggesting the need for further attention and audit of the Robson groups that significantly influence the overall CS rate. The study results will help policymakers identify effective strategies to reduce the CS rate in Iran, providing appropriate benchmarking to compare obstetric care with other countries that have better maternal and perinatal outcomes.

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http://hdl.handle.net/10453/155908