Abstract
Objective:This study was aimed to elucidate the prevalence-pattern and determinant of cesarean section (CS) in a multiethnic cohort from Pakistan.Methods:Through a cross-sectional study design, women delivering at a tertiary care center were recruited during 2013-2017. Data on socio-demographic variables, obstetric complications and birth outcome were obtained. Descriptive statistics, bivariate and multivariate logistic regression analyses were performed.Results:A total of 5,275 pregnant women were recruited and 43% of the deliveries underwent CS. Odds of CS were significantly higher in subjects originating from Azad JammuKashmir and Sindh regions, speaking Potohari and Pahari languages, women in advance ages, and those who were housewives. CS had significantly lower odds of prenatal mortality but increased odds of postnatal mortality. Obstetric factors that appeared to be significant predictors of CS were multiparity, breech position, fetal distress, oligohydroamniosis, preeclampsia, and previous scar.Conclusion:This study revealed high variability in CS in various socio-demographic strata of study population. The obstetric complications highlighted in this study may be reduced by proper perinatal counseling and pregnancy monitoring and should be the focus of intervention programs as suggested in the Millennium Development Goals.
Highlights
In a woman’s life span, pregnancy is a critical period being recognized as welcome event for successful womanhood,[1] while delivery is one of the1
Women originating from Azad Jammu-Kashmir (AJK) (AOR:1.33; 95% CI:0.97–1.81) and Sindh province (AOR:1.32; 95% CI:0.88-1.97) were more likely to deliver children by cesarean section (CS)
Women speaking Potohari (AOR:1.47; 95% CI: 1.03-2.10), Urdu (AOR:1.35; 95% CI: 0.96-1.92), Pahari (AOR:1.34; 95% CI: 0.99-1.83) and Saraiki (AOR:1.34; 95% CI: 0.85-2.11) languages were more likely to have CS
Summary
In a woman’s life span, pregnancy is a critical period being recognized as welcome event for successful womanhood,[1] while delivery is one of the. Correspondence: July 2, 2020 January 8, 2021 most crucial period of pregnancy culminating in birth of baby. Modes of delivery can be either the natural (vaginal) or by surgical intervention (Cesarean section; CS). The rate of Cesarean section (CSR) is continuously rising in many countries around the globe and has exceeded the level of 10–15% which is recommended by World Health Organization.[2,3] Unnecessary CS may be associated with an increased risk of maternal and neonatal mortality, long-term health of child and mothers as well as future pregnancies.[3,4]
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