Document Detail


Determinants of caesarean section in Lebanon: geographical differences.
MedLine Citation:
PMID:  18298687     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
This study, based on the Lebanese National Perinatal Survey which included 5231 women, examined the relations between the caesarean section (CS) rate and the characteristics of mothers, children, antenatal care and maternity units in two geographical zones of Lebanon (Beirut-Mount Lebanon and the rest of the country) and then looked at geographical variations. This analysis concerned 3846 women with singleton pregnancies and livebirths at low risk of CS, after exclusion of women with a previous CS, non-cephalic fetal presentations, or delivery before 37 weeks' gestation. The principal end point was caesarean delivery. The relations between the factors studied and CS were estimated by odds ratios (OR), both crude and adjusted, using logistic regression. The rate of CS was higher in the Beirut-Mount Lebanon zone than elsewhere (13.4% vs. 7.6%). After adjustment, several factors remained associated with caesarean delivery in each zone. Common factors were primiparity, gestational age > or = 41 weeks and antenatal hospitalisation. Factors identified only in the Beirut-Mount Lebanon zone were obstetric history and insurance coverage, whereas for the other zones we only found major risk factors for obstetric disease: maternal age > or = 35 years, number of antenatal consultations > or = 4 and birthweight < or = 2500 g. The multivariable analysis of the overall population, adjusting for zone of delivery and other variables, shows that zone was one of the principal factors associated with the risk of caesarean delivery in Lebanon (OR = 1.80 [95% CI 1.09, 2.95]). In conclusion, the CS rates in Lebanon were high, with geographical differences that were associated with access to care and with obstetric practices.
Authors:
Marion Carayol; Ali Zein; Nada Ghosn; Christiane Du Mazaubrun; Gérard Breart
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Paediatric and perinatal epidemiology     Volume:  22     ISSN:  1365-3016     ISO Abbreviation:  Paediatr Perinat Epidemiol     Publication Date:  2008 Mar 
Date Detail:
Created Date:  2008-02-26     Completed Date:  2008-05-19     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8709766     Medline TA:  Paediatr Perinat Epidemiol     Country:  England    
Other Details:
Languages:  eng     Pagination:  136-44     Citation Subset:  IM    
Affiliation:
Epidemiological Research Unit on Perinatal Health and Women's Health, INSERM U149, Paris, France. carayol@cochin.inserm.fr
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MeSH Terms
Descriptor/Qualifier:
Adult
Analysis of Variance
Birth Weight
Cesarean Section / statistics & numerical data*
Female
Gestational Age
Humans
Lebanon
Maternal Age
Odds Ratio
Pregnancy
Risk Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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