Analysis of cesarean delivery rate and indications of cesarean section in Jiangsu Province from 2012 to 2014

Abstract

Objective By analyzing the cesarean delivery rate (CDR) and the indications of cesareansection in Jiangsu Province from 2012 to 2014, to find the strategy to reduce CDR. Methods Data of40 hospitals whose number of delivery was over 2 400 per year from the database of the Quality Control Center of Gynecology and Obstetrics of Jiangsu Province from 2012 to 2014 were selected. The cohort was divided intotwo groups, one was specialized hospital including 11 maternal and child health hospitals and the other included29 general hospitals. After analyzing the current status of cesarean section of the whole province, the average CDR and the distribution of the first indications of cesarean section in two groups were compared usingChi-square test. Results The average CDRs at year 2012, 2013 and 2014 were 53.8%(96 347/178 970), 51.8% (97 509/188 142) and 48.8%(106 323/217 877), which had a trend of decrease (χ2=1 026.2,P 0.05). The three main first indications of cesarean section were associated and postoperative pregnancy complications, and no medical indications. Interestingly, from 2012 to 2014, the CDR for scarred uterus in specialized hospitals raised from 5.4% to 20.3%, and that in general hospitals increased from 6.7% to 21.6%, which became the first. Conclusions The average CDR in Jiangsu Province tends to decrease each year, so does the CDR without medical indications. The first indication of cesarean section is associated or postoperative pregnancy complications, while scarred uterus becomes the most common in cesarean section. Key words: Cesarean section; Choice behavior