ArticleBMC pregnancy and childbirth2014
Determinants of cesarean delivery: a classification tree analysis.
Article in BMC pregnancy and childbirth, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 2 of them syntheses that pooled it.
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Who cites it
14 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Caesarean sections in teaching hospitals: systematic review and meta-analysis of hospitals in 22 countries.BMJ open · 2021Pooled it
- "An unnecessary cut?" multilevel health systems analysis of drivers of caesarean sections rates in Italy: a systematic review.BMC pregnancy and childbirth · 2020Pooled it
- "Everywhere you see, C-sections are happening": examining trends and reasons for a rise in cesarean-section deliveries among women in urban informal settlements, Mumbai Metropolitan Region, using a mixed methods approach.BMC pregnancy and childbirth · 2026Article
- Racial inequities in cesarean use among high- and low-risk deliveries: An analysis of childbirth hospitalizations in New Jersey from 2000 to 2015.Health services research · 2025Article
- An AI-based approach to predict delivery outcome based on measurable factors of pregnant mothers.PLOS digital health · 2025Article
- Office hours and caesarean section: systematic review and Meta-analysis.Research in health services & regions · 2022Review
- Cesarean section in Uruguay from 2008 to 2018: country analysis based on the Robson classification. An observational study.BMC pregnancy and childbirth · 2022Observational
- Public-private differentials in health care delivery: the case of cesarean deliveries in Algeria.International journal of health economics and management · 2021Article
- Understanding Factors Leading to Primary Cesarean Section and Vaginal Birth After Cesarean Delivery in the Friuli-Venezia Giulia Region (North-Eastern Italy), 2005-2015.Scientific reports · 2020Article
- A Systematic Evaluation of Hospital Performance of Childbirth Delivery Modes and Associated Factors in the Friuli Venezia Giulia Region (North-Eastern Italy), 2005-2015.Scientific reports · 2019Article
- Impact of Gestational Weight Gain on Cesarean Delivery Risk, Perinatal Birth Weight and Gestational Age in Women with Normal Pre-pregnancy BMI.Journal of obstetrics and gynaecology of India · 2018Article
- Determinants of unjustified cesarean section in two hospitals southwestern Ethiopia: retrospective record review.BMC research notes · 2018Article
- Factors leading to cesarean section delivery at Felegehiwot referral hospital, Northwest Ethiopia: a retrospective record review.Reproductive health · 2016Article
- Forceps, Actual Use, and Potential Cesarean Section Prevention: Study in a Selected Mexican Population.Journal of pregnancy · 2015Article
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCesarean delivery (CD) rates are rising in many parts of the world. To define strategies to reduce them, it is important to identify their clinical and organizational determinants. The objective of this cross-sectional study is to identify sub-types of women at higher risk of CD using demographic, clinical and organizational variables.
methodsAll hospital discharge records of women who delivered between 2005 and mid-2010 in the Emilia-Romagna Region of Italy were retrieved and linked with birth certificates. Sociodemographic and clinical information was retrieved from the two data sources. Organizational variables included activity volume (number of births per year), hospital type, and hour and day of delivery. A classification tree analysis was used to identify the variables and the combinations of variables that best discriminated cesarean from vaginal delivery.
resultsThe classification tree analysis indicated that the most important variables discriminating the sub-groups of women at different risk of cesarean section were: previous cesarean, mal-position/mal-presentation, fetal distress, and abruptio placentae or placenta previa or ante-partum hemorrhage. These variables account for more than 60% of all cesarean deliveries. A sensitivity analysis identified multiparity and fetal weight as additional discriminatory variables.
conclusionsClinical variables are important predictors of CD. To reduce the CD rate, audit activities should examine in more detail the clinical conditions for which the need of CD is questionable or inappropriate.
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