Factors associated with cesarean deliveries at Women Specialized Hospital Riyadh, King Fahd Medical City, Kingdom of Saudi Arabia

Abstract

The risks and safety of cesarean section (CS) differ from place to place in the world. According to the World Health Organization, the best outcomes for mothers and babies appear to occur with CS rates of 5-15%. Increasing maternal age and high parity are among the chief determinants of cesarean deliveries. A retrospective cohort study was done at the tertiary care facility, King Fahd Medical City, Riyadh from 1 January to 31 December 2008. Observations were recorded from the labor ward registers. Sample size estimated was n=2192. A total of 2907 patients were recruited. All CS at viable gestation were included. Vaginal deliveries were taken as the comparison group. Non probability convenient sampling was done. Factors associated with cesarean deliveries were analyzed using univariate and bivariate analysis methods. Level of significance was set at P≤0.05 and confidence interval (CI)=95% respectively. Independent sample t test and Pearson's chi-square test showed that increasing maternal age, parity (P=0.0001 and 0.002 respectively), and prematurity (P=0.0001) were significant associates for CS. Binary logistic regression also confirmed significant association of increasing parity and prematurity (P=0.02 and 0.0001 respectively). Non-reassuring cardiotocography was the most common indication for CS. Increasing maternal age and parity as well as prematurity were the factors significantly associated with CS. Fetomaternal outcome was comparable between vaginal and abdominal deliveries, despite the high CS rate. Non-reassuring cardiotocography was the most common indication. Secondary tests for evaluation of fetal well being might help to reduce the high CS rate.