Delivery settings and caesarean section rates in China

Sufang, G; Padmadas, SS; Fengmin, Z; Brown, JJ; William Stones, R

Delivery settings and caesarean section rates in China

Sufang, G Padmadas, SS Fengmin, Z Brown, JJ

William Stones, R

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Publication Type:: Journal Article
Citation:: Bulletin of the World Health Organization, 2007, 85 (10), pp. 755 - 762
Issue Date:: 2007-01-01

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Field	Value	Language
dc.contributor.author	Sufang, G	en_US
dc.contributor.author	Padmadas, SS	en_US
dc.contributor.author	Fengmin, Z	en_US
dc.contributor.author	Brown, JJ https://orcid.org/0000-0002-7535-2874	en_US
dc.contributor.author	William Stones, R	en_US
dc.date.issued	2007-01-01	en_US
dc.identifier.citation	Bulletin of the World Health Organization, 2007, 85 (10), pp. 755 - 762	en_US
dc.identifier.issn	0042-9686	en_US
dc.identifier.uri	http://hdl.handle.net/10453/28002
dc.description.abstract	Objective: To quantify the influence of increasing use of health-care services on rising rates of caesarean section in China. Methods: We used data from a population-based survey conducted by the United Nations Population Fund during September 2003 in 30 selected counties in three regions of China. The study sample (derived from birth history schedule) consisted of 3803 births to mothers aged less than 40 years between 1993 and 2002. Multiple logistic regression models were used to estimate the effect of health-care factors on the odds of a caesarean section, controlling for time and selected variables. Findings: Institutional births increased from 53.5% in 1993-1994 to 82.2% in 2001-2002, while the corresponding increase in births by caesarean section was from 8.9% to 24.8%, respectively. Decomposition analysis showed that 69% of the increase in rates of caesarean section was driven by the increase in births within institutions. The adjusted odds of a caesarean section were 4.6 times (95% confidence interval, CI: 3.4-11.8) higher for recent births. The adjusted odds were also significantly higher for mothers who had at least one antenatal ultrasound test. Rates of caesarean section in secondary-level facilities markedly increased over the last decade to the same levels as in major hospitals ( P < 0.001). Conclusion: The upsurge in rates of births by caesarean section in this population cannot be fully explained by increases in institutional births alone, but is likely to be driven by medical practice within secondary-level hospitals and women's demand for the procedure.	en_US
dc.relation.ispartof	Bulletin of the World Health Organization	en_US
dc.relation.isbasedon	10.2471/BLT.06.035808	en_US
dc.subject.classification	Tropical Medicine	en_US
dc.title	Delivery settings and caesarean section rates in China	en_US
dc.type	Journal Article
utslib.citation.volume	10	en_US
utslib.citation.volume	85	en_US
utslib.for	11 Medical and Health Sciences	en_US
pubs.embargo.period	Not known	en_US
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Science
pubs.organisational-group	/University of Technology Sydney/Faculty of Science/School of Mathematical and Physical Sciences
utslib.copyright.status	closed_access
pubs.issue	10	en_US
pubs.publication-status	Published	en_US
pubs.volume	85	en_US

Abstract:

Objective: To quantify the influence of increasing use of health-care services on rising rates of caesarean section in China. Methods: We used data from a population-based survey conducted by the United Nations Population Fund during September 2003 in 30 selected counties in three regions of China. The study sample (derived from birth history schedule) consisted of 3803 births to mothers aged less than 40 years between 1993 and 2002. Multiple logistic regression models were used to estimate the effect of health-care factors on the odds of a caesarean section, controlling for time and selected variables. Findings: Institutional births increased from 53.5% in 1993-1994 to 82.2% in 2001-2002, while the corresponding increase in births by caesarean section was from 8.9% to 24.8%, respectively. Decomposition analysis showed that 69% of the increase in rates of caesarean section was driven by the increase in births within institutions. The adjusted odds of a caesarean section were 4.6 times (95% confidence interval, CI: 3.4-11.8) higher for recent births. The adjusted odds were also significantly higher for mothers who had at least one antenatal ultrasound test. Rates of caesarean section in secondary-level facilities markedly increased over the last decade to the same levels as in major hospitals ( P < 0.001). Conclusion: The upsurge in rates of births by caesarean section in this population cannot be fully explained by increases in institutional births alone, but is likely to be driven by medical practice within secondary-level hospitals and women's demand for the procedure.

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http://hdl.handle.net/10453/28002