Abstract
Objective The objective of this study was to assess the determinants of cesarean section deliveries in public hospitals of Addis Ababa, Ethiopia, 2019. Method A hospital-based unmatched case-control study was conducted to study 780 (260 cases and 520 controls) women who delivered in public hospitals of Addis Ababa from August 22 to September 20, 2019. The cases were all mothers who delivered through caesarean section, and controls were all mothers who delivered vaginally in the same time in the study area. Data were collected from the randomly selected women and looking into their cards. Data were entered on EpiData 3.1 and exported to SPSS version 20 for cleaning and analyzing. Binary logistic regression and AOR with 95% CI were used to assess the determinants of caesarean section. Results Majority of the study participants were in the age category 20–34 years. Nearly more than 1/3rd of the participants (32.7% cases and 34.6% controls) have attended primary school. Most of the cases 217 (83.5%) and few of the controls 21 (4%) possess previous caesarean section. One hundred three (52.3%) of the cases and 329 (63.6%) controls were multi-parous. Previous caesarean delivery (AOR = 6.93, 95% CI; (3.39, 14.16)), singleton pregnancy (AOR = 0.34, 95% CI; (0.12, 0.83)), birth weight less than 2500 gm (AOR = 0.29, 95% CI; (0.18, 0.92)), birth weight greater than 4000 gm (AOR = 16.15 (8.22, 31.74)), completely documented partograph (AOR = 0.13, 95% CI; (0.078, 0.23)), and pregnancy-induced hypertension (AOR = 2.44, 95% CI; (1.46, 4.08)) were significant determinants of caesarean delivery in this study. Conclusion Previous caesarean section, number of delivery, birth weight, partograph documentation, and pregnancy-induced hypertension had significant association with caesarean section delivery in this study.
Highlights
College and Addis Ababa public health research and emergency management care process. e participants were informed about the objective clearly and were informed that the information they provided is only used for research purposes and kept confidential
The collected data were entered on EpiData3.1 and exported to SPSS version 20 for analysis. e variables with p < 0.25 on bivariate logistic regression were taken to multivariable logistic regression to control possible confounding factors
Mothers who underwent previous caesarean section (CS) were 6.93 times more likely to deliver by CS for the consecutive birth compared with those who gave birth via vaginal delivery. is finding is consistent with the studies conducted in Bahir Dar, Harar, Addis Ababa, Mekelle, and Dessie [20,21,22,23,24]. is might be due to the fear of uterine rupture associated with waiting longer time
Summary
A quantitative facility-based unmatched casecontrol study design was applied to study a total of 780 participant mothers from August 22 to September 20, 2019. E data for this study were collected after ethical clearance was obtained from Gamby Medical and Business. E participants were informed about the objective clearly and were informed that the information they provided is only used for research purposes and kept confidential. Cases are mothers who delivered by caesarean section, whereas controls are those who delivered vaginally. Prolonged premature rupture of membrane is defined as duration of rupture of the membrane greater than 12 hours before the onset of labor [19]. Duration of labor: the duration of labor in this study is measured from the onset of true labor including the latent phase of first stage of labor to third stage of labor
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