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A global reference for caesarean section rates (C-Model): a multicountry cross-sectional study.
Souza, J P; Betran, A P; Dumont, A; de Mucio, B; Gibbs Pickens, C M; Deneux-Tharaux, C; Ortiz-Panozo, E; Sullivan, E; Ota, E; Togoobaatar, G; Carroli, G; Knight, H; Zhang, J; Cecatti, J G; Vogel, J P; Jayaratne, K; Leal, M C; Gissler, M; Morisaki, N; Lack, N; Oladapo, O T; Tunçalp, Ö; Lumbiganon, P; Mori, R; Quintana, S; Costa Passos, A D; Marcolin, A C; Zongo, A; Blondel, B; Hernández, B; Hogue, C J; Prunet, C; Landman, C; Ochir, C; Cuesta, C; Pileggi-Castro, C; Walker, D; Alves, D; Abalos, E; Moises, Ecd; Vieira, E M; Duarte, G; Perdona, G; Gurol-Urganci, I; Takahiko, K; Moscovici, L; Campodonico, L; Oliveira-Ciabati, L; Laopaiboon, M; Danansuriya, M.
Afiliación
  • Souza JP; Department of Social Medicine, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil.
  • Betran AP; Department of Reproductive Health and Research, UNDP-UNFPA-UNICEF-WHO World Bank Special Programme of Research, Development and Research Training in Human Reproduction, WHO, Geneva, Switzerland.
  • Dumont A; Research Institute for Development, Université Paris Descartes, Sorbonne Paris Cité, UMR 216, Paris, France.
  • de Mucio B; Latin American Center for Perinatology, Women and Reproductive Health, (CLAP/WR), WHO Regional Office for the Americas, Montevideo, Uruguay.
  • Gibbs Pickens CM; Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
  • Deneux-Tharaux C; Inserm U1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team, Center for Epidemiology and Biostatistics, Paris Descartes University, Paris, France.
  • Ortiz-Panozo E; Center for Population Health Research, National Institute of Public Health, Cuernavaca, Mexico.
  • Sullivan E; Faculty of Health, University of Technology, Sydney, NSW, Australia.
  • Ota E; Department of Health Policy, National Center for Child Health and Development, Tokyo, Japan.
  • Togoobaatar G; Department of Health Policy, National Center for Child Health and Development, Tokyo, Japan.
  • Carroli G; Centro Rosarino de Estudios Perinatales, Rosario, Argentina.
  • Knight H; Royal College of Obstetricians and Gynaecologists, Office for Research and Clinical Audit, Lindsay Stewart R&D Centre, London, UK.
  • Zhang J; Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK.
  • Cecatti JG; Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
  • Vogel JP; Department of Obstetrics and Gynaecology, School of Medical Sciences, University of Campinas (UNICAMP), Campinas, SP, Brazil.
  • Jayaratne K; Department of Reproductive Health and Research, UNDP-UNFPA-UNICEF-WHO World Bank Special Programme of Research, Development and Research Training in Human Reproduction, WHO, Geneva, Switzerland.
  • Leal MC; Family Health Bureau, Ministry of Health, Colombo, Sri Lanka.
  • Gissler M; Escola Nacional de Saúde Pública (ENSP), Fundação Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, Brazil.
  • Morisaki N; National Institute for Health and Welfare, Helsinki, Finland.
  • Lack N; Department of Health Policy, National Center for Child Health and Development, Tokyo, Japan.
  • Oladapo OT; Department of Paediatrics, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.
  • Tunçalp Ö; Bayerische Arbeitsgemeinschaft für Qualitätssicherung in der Stationären Versorgung (BAQ), Bayerische Krankenhausgesellschaft, Munich, Germany.
  • Lumbiganon P; Department of Reproductive Health and Research, UNDP-UNFPA-UNICEF-WHO World Bank Special Programme of Research, Development and Research Training in Human Reproduction, WHO, Geneva, Switzerland.
  • Mori R; Department of Reproductive Health and Research, UNDP-UNFPA-UNICEF-WHO World Bank Special Programme of Research, Development and Research Training in Human Reproduction, WHO, Geneva, Switzerland.
  • Quintana S; Department of Obstetrics and Gynecology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.
  • Costa Passos AD; Department of Health Policy, National Center for Child Health and Development, Tokyo, Japan.
  • Marcolin AC; Department of Gynaecology and Obstetrics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil.
  • Zongo A; Department of Social Medicine, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil.
  • Blondel B; Department of Gynaecology and Obstetrics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil.
  • Hernández B; Research Institute for Development, Université Paris Descartes, Sorbonne Paris Cité, UMR 216, Paris, France.
  • Hogue CJ; Direction de la santé de la famille, Ministère de la Santé, Ouagadougou, Burkina Faso.
  • Prunet C; Inserm U1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team, Center for Epidemiology and Biostatistics, Paris Descartes University, Paris, France.
  • Landman C; Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.
  • Ochir C; Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
  • Cuesta C; Inserm U1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team, Center for Epidemiology and Biostatistics, Paris Descartes University, Paris, France.
  • Pileggi-Castro C; Escola Nacional de Saúde Pública (ENSP), Fundação Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, Brazil.
  • Walker D; School of Public Health, Health Sciences University of Mongolia, Ulaanbaatar, Mongolia.
  • Alves D; Centro Rosarino de Estudios Perinatales, Rosario, Argentina.
  • Abalos E; GLIDE Technical Cooperation and Research, Ribeirão Preto, SP, Brazil.
  • Moises E; Department of Paediatrics, Ribeirão Preto Medical School, University of Sao Paulo, Ribeirão Preto, SP, Brazil.
  • Vieira EM; Departments of Obstetrics & Gynaecology and Global Health Sciences, University of California, San Francisco, CA, USA.
  • Duarte G; Department of Social Medicine, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil.
  • Perdona G; Centro Rosarino de Estudios Perinatales, Rosario, Argentina.
  • Gurol-Urganci I; Department of Gynaecology and Obstetrics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil.
  • Takahiko K; Department of Social Medicine, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil.
  • Moscovici L; Department of Gynaecology and Obstetrics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil.
  • Campodonico L; Department of Social Medicine, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil.
  • Oliveira-Ciabati L; Royal College of Obstetricians and Gynaecologists, Office for Research and Clinical Audit, Lindsay Stewart R&D Centre, London, UK.
  • Laopaiboon M; Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK.
  • Danansuriya M; Department of Health Policy, National Center for Child Health and Development, Tokyo, Japan.
BJOG ; 123(3): 427-36, 2016 Feb.
Article en En | MEDLINE | ID: mdl-26259689
OBJECTIVE: To generate a global reference for caesarean section (CS) rates at health facilities. DESIGN: Cross-sectional study. SETTING: Health facilities from 43 countries. POPULATION/SAMPLE: Thirty eight thousand three hundred and twenty-four women giving birth from 22 countries for model building and 10,045,875 women giving birth from 43 countries for model testing. METHODS: We hypothesised that mathematical models could determine the relationship between clinical-obstetric characteristics and CS. These models generated probabilities of CS that could be compared with the observed CS rates. We devised a three-step approach to generate the global benchmark of CS rates at health facilities: creation of a multi-country reference population, building mathematical models, and testing these models. MAIN OUTCOME MEASURES: Area under the ROC curves, diagnostic odds ratio, expected CS rate, observed CS rate. RESULTS: According to the different versions of the model, areas under the ROC curves suggested a good discriminatory capacity of C-Model, with summary estimates ranging from 0.832 to 0.844. The C-Model was able to generate expected CS rates adjusted for the case-mix of the obstetric population. We have also prepared an e-calculator to facilitate use of C-Model (www.who.int/reproductivehealth/publications/maternal_perinatal_health/c-model/en/). CONCLUSIONS: This article describes the development of a global reference for CS rates. Based on maternal characteristics, this tool was able to generate an individualised expected CS rate for health facilities or groups of health facilities. With C-Model, obstetric teams, health system managers, health facilities, health insurance companies, and governments can produce a customised reference CS rate for assessing use (and overuse) of CS. TWEETABLE ABSTRACT: The C-Model provides a customized benchmark for caesarean section rates in health facilities and systems.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Cesárea / Modelos Estadísticos Tipo de estudio: Clinical_trials / Observational_studies / Prevalence_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Female / Humans / Pregnancy Idioma: En Revista: BJOG Asunto de la revista: GINECOLOGIA / OBSTETRICIA Año: 2016 Tipo del documento: Article País de afiliación: Brasil Pais de publicación: Reino Unido
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Cesárea / Modelos Estadísticos Tipo de estudio: Clinical_trials / Observational_studies / Prevalence_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Female / Humans / Pregnancy Idioma: En Revista: BJOG Asunto de la revista: GINECOLOGIA / OBSTETRICIA Año: 2016 Tipo del documento: Article País de afiliación: Brasil Pais de publicación: Reino Unido