Abstract
Cesarean section (CS) is associated with maternal morbidity and mortality in developing countries. This study is conducted to assess factors associated with CS in Pakistan using partial least squares (PLS) algorithm, where categorical factors are modeled. Nationally representative maternal data from Pakistan Demographic and Health Surveys (PDHS) conducted during 2012-2013 is used in this study. Among correlation coefficient based PLS regression proposed algorithms for categorical factors, Pearson’s Contingency Coefficient (CC) PLS coupled with loading weight (LW) appeared to be the most efficient method in terms of model performance and influential factor selection. Region of residence, type of place of residence, mother’s and her partner’s level of education, wealth index, year of birth, previous terminated pregnancy, use of contraception, prenatal care provided by a doctor and nurse/midwife/LHV (lady health visitor), assistance provided by a nurse/midwife/LHV,number of antenatal visits, size of child, antenatal care provided by government hospital, transport facility for medical care, baby birth status, mother’s age at first birth, preceding birth interval and vaccination of hepatitis B-1 and B2 are found to be significantly affecting the CS delivery method. Correlation coefficient based PLS regression algorithms may serve more efficiently as a multivariate technique to treat high-dimensional categorical data.
Highlights
Cesarean section (CS) delivery rates have accelerated in recent decades [35, 57]
Cramer’s V and Phi correlation coefficients are used to detect the presence of multicollinearity in the nominal data
This study identified the factors associated with cesarean section (CS) using a representative sample data extracted from Pakistan demographic and health survey (PDHS) 2012-13
Summary
Cesarean section (CS) delivery rates have accelerated in recent decades [35, 57]. CS is a surgical technique adopted to prevent medical complications and maternal/fetal mortality during delivery [4]. High quality differential maternal health care facility is a vital necessity for every woman across the world [40]. Unnecessary CS may result in an increased hazard of maternal as well as neonatal deaths [7]. The world health organization (WHO) seriously noticed and evaluated the high CS rate in 2015. Considering two conditions; necessity of CS and avoiding needless CS, WHO recommended to set 5-15% CS rate to rescue the maternal/ neonatal lives in essential conditions but avoid unnecessary CS surgery [48]
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