Abstract
Abstract Introduction: Brazil presents high C-section prevalence rates. Several factors may be associated with such high rates. Objective: To observe and analyze factors associated with the prevalence of cesarean sections in Brazil, according to their occurrence in Brazilian regions. Methods: An ecological study, having C-section as the outcome, from 1990 to 2013, in Brazilian regions, using data from the Brazilian National Health Survey, 2013. Records of women in their reproductive period, aged between 18 and 49 years, were included, totaling a sample of 16,175 women. Descriptive and bivariate analysis was carried out with logistic regression. Results: The prevalence of cesarean sections in Brazil was 53.03%. Vaginal delivery was more prevalent in the North (52.74%) and Northeast (51.06%) regions, while C-section was more prevalent in the Southeast (59.32%), South (56.96%) and Midwest (61.48%) regions. Over the years, an increased probability of cesarean sections was observed, particularly in the following regions: Northeast (2.21 times more, CI95%: 1,42 - 3,46) and South (2.75 times more, CI95%: 1,44 - 5,23). Women with higher levels of education are 2.05 times (CI95%: 1.27 - 3.30) more likely to have a C-section, especially those in the Northern and Southern regions. In the Northeast, this probability increased, regardless of the level of education. Conclusion: The prevalence of cesarean sections in Brazil is high and, over the years, factors such as level of education, maternal age and having health insurance, seem to contribute to the increase in surgical deliveries.
Highlights
IntroductionSeveral factors may be associated with such high rates
This scenario can be justified both by social, demographic, cultural and economic factors of pregnant women, and mother’s choice for type of delivery and factors related to the care model developed in these countries, involving aspects of medical work and the work of other professionals, medical preferences and economic interests of the parties in this process. These findings tend to corroborate with our study, which showed a prevalence of 53.03% of C-sections in Brazil
Brazil continues to have high C-section rates, with more than half of newborns delivered by surgical procedure
Summary
Several factors may be associated with such high rates. Objective: To observe and analyze factors associated with the prevalence of cesarean sections in Brazil, according to their occurrence in Brazilian regions. Results: The prevalence of cesarean sections in Brazil. Pathological cardiotocography, failure of labor progress and previous C-section are among the related indications. C-section, if correctly indicated, is effective in reducing maternal and perinatal mortality. It has been carried out indiscriminately in most of the world [1, 4]. Since 1985, the international medical community considers the 10%-15%-rate of C-sections ideal for any region of the world. A continuous increase can be observed in this rate in recent decades, both in developed and developing countries [5]
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