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Cesarean section trends in the Nordic Countries - a comparative analysis with the Robson classification.
Pyykönen, Aura; Gissler, Mika; Løkkegaard, Ellen; Bergholt, Thomas; Rasmussen, Steen C; Smárason, Alexander; Bjarnadóttir, Ragnheiður I; Másdóttir, Birna B; Källén, Karin; Klungsoyr, Kari; Albrechtsen, Susanne; Skjeldestad, Finn E; Tapper, Anna-Maija.
Afiliación
  • Pyykönen A; University of Helsinki, Helsinki, Finland.
  • Gissler M; Department of Obstetrics and Gynecology, Helsinki University Hospital, Helsinki, Finland.
  • Løkkegaard E; National Institute for Health and Welfare THL, Helsinki, Finland.
  • Bergholt T; Department of Neurobiology, Care Sciences and Society, Division of Family Medicine, Karolinska Institute, Stockholm, Sweden.
  • Rasmussen SC; University of Copenhagen, Copenhagen, Denmark.
  • Smárason A; Department of Obstetrics and Gynecology, Nordsjaelland Hospital, Hillerod, Denmark.
  • Bjarnadóttir RI; University of Copenhagen, Copenhagen, Denmark.
  • Másdóttir BB; Department of Obstetrics, Rigshospitalet, Copenhagen, Denmark.
  • Källén K; University of Copenhagen, Copenhagen, Denmark.
  • Klungsoyr K; Department of Obstetrics, Rigshospitalet, Copenhagen, Denmark.
  • Albrechtsen S; The Icelandic Birth Registry, Akureyri, Iceland.
  • Skjeldestad FE; Institute of Health Science Research, University of Akureyri, Akureyri, Iceland.
  • Tapper AM; The Icelandic Birth Registry, Akureyri, Iceland.
Acta Obstet Gynecol Scand ; 96(5): 607-616, 2017 May.
Article en En | MEDLINE | ID: mdl-28176334
INTRODUCTION: The cesarean rates are low but increasing in most Nordic countries. Using the Robson classification, we analyzed which obstetric groups have contributed to the changes in the cesarean rates. MATERIAL AND METHODS: Retrospective population-based registry study including all deliveries (3 398 586) between 2000 and 2011 in Denmark, Finland, Iceland, Norway and Sweden. The Robson group distribution, cesarean rate and contribution of each Robson group were analyzed nationally for four 3-year time periods. For each country, we analyzed which groups contributed to the change in the total cesarean rate. RESULTS: Between the first and the last time period studied, the total cesarean rates increased in Denmark (16.4 to 20.7%), Norway (14.4 to 16.5%) and Sweden (15.5 to 17.1%), but towards the end of our study, the cesarean rates stabilized or even decreased. The increase was explained mainly by increases in the absolute contribution from R5 (women with previous cesarean) and R2a (induced labor on nulliparous). In Finland, the cesarean rate decreased slightly (16.5 to 16.2%) mainly due to decrease among R5 and R6-R7 (breech presentation, nulliparous/multiparous). In Iceland, the cesarean rate decreased in all parturient groups (17.6 to 15.3%), most essentially among nulliparous women despite the increased induction rates. CONCLUSIONS: The increased total cesarean rates in the Nordic countries are explained by increased cesarean rates among nulliparous women, and by an increased percentage of women with previous cesarean. Meanwhile, induction rates on nulliparous increased significantly, but the impact on the total cesarean rate was unclear. The Robson classification facilitates benchmarking and targeting efforts for lowering the cesarean rates.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Cesárea / Bases de Datos Factuales Tipo de estudio: Observational_studies Límite: Female / Humans / Newborn / Pregnancy País/Región como asunto: Europa Idioma: En Revista: Acta Obstet Gynecol Scand Año: 2017 Tipo del documento: Article País de afiliación: Finlandia Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Cesárea / Bases de Datos Factuales Tipo de estudio: Observational_studies Límite: Female / Humans / Newborn / Pregnancy País/Región como asunto: Europa Idioma: En Revista: Acta Obstet Gynecol Scand Año: 2017 Tipo del documento: Article País de afiliación: Finlandia Pais de publicación: Estados Unidos