Cesarean birth in the Global Network for Women’s and Children’s Health Research: trends in utilization, risk factors, and subgroups with high cesarean birth rates
Background
Globally, cesarean birth rates are on the rise. Many countries have exceeded the World Health Organization (WHO) recommended cesarean birth rate of 10–15%, with some regions experiencing rates over 40%. Conversely, very low resource regions that may have poor access to facility birth, and subsequently cesarean birth, often fall below the recommended range. Cesarean birth rates within the Global Network for Women’s and Children’s Health Research (Global Network) have been increasing, paralleling the global trend. The Global Network prospectively collects population-based data on home and facility births in six low- and middle-income countries that span Latin America, sub-Saharan Africa, and Southeast Asia in an ongoing registry. Data from this Maternal Newborn Health Registry (MNHR) within the Global Network was previously analyzed to show that over a relatively short period of time (2010–2016), cesarean birth rates doubled at all non-sub-Saharan African sites, almost reaching 30% in one Indian site. Rates at the sub-Saharan African sites were well below 5%, despite also nearly doubling across the time period studied. Given these trends, this study serves to update the analysis of cesarean birth rates in the Global Network, to observe risk factors associated with cesarean birth (our primary outcome), and to consider subgroups contributing to the cesarean birth rates (our secondary outcome).
By: Harrison MS, Garces AL, Patel A, Hibberd PL, Goudar SS, Saleem S, et al.