Evidence map›Paper›PMID 26259689›Full record

ArticleBJOG : an international journal of obstetrics and gynaecology2016

A global reference for caesarean section rates (C-Model): a multicountry cross-sectional study.

J P Souza, A P Betran, A Dumont, B de Mucio, C M Gibbs Pickens, C Deneux-Tharaux, E Ortiz-Panozo, E Sullivan, E Ota, G Togoobaatar and 54 more

Registry-linked trialAbstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in BJOG : an international journal of obstetrics and gynaecology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06359223 (Effect of Coffee Consumption on Postoperative Pain and Intestinal Motility After Caesarean Section), which is not on this map. Cited by 52 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
52citing papers in PubMed, 4 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT06359223 nacompletednot on this mapstarted 2024, after this paper: background citation

Effect of Coffee Consumption on Postoperative Pain and Intestinal Motility After Caesarean Section: Randomized Controlled Study

TypeinterventionalSponsorTC Erciyes UniversityRan2024 to 2024Enrolled57ConditionsOperation, Cesarean SectionArmscoffee consumption, control group
3 · Its place in the literature

Who cites it

52 citing papers in PubMed, 4 syntheses or guidelines pooled it.

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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

64 authors.

J P SouzaDepartment of Social Medicine, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil.
A P BetranDepartment of Reproductive Health and Research, UNDP-UNFPA-UNICEF-WHO World Bank Special Programme of Research, Development and Research Training in Human Reproduction, WHO, Geneva, Switzerland.
A DumontResearch Institute for Development, Université Paris Descartes, Sorbonne Paris Cité, UMR 216, Paris, France.
B de MucioLatin American Center for Perinatology, Women and Reproductive Health, (CLAP/WR), WHO Regional Office for the Americas, Montevideo, Uruguay.
C M Gibbs PickensDepartment of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
C Deneux-TharauxInserm U1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team, Center for Epidemiology and Biostatistics, Paris Descartes University, Paris, France.
E Ortiz-PanozoCenter for Population Health Research, National Institute of Public Health, Cuernavaca, Mexico.
E SullivanFaculty of Health, University of Technology, Sydney, NSW, Australia.
E OtaDepartment of Health Policy, National Center for Child Health and Development, Tokyo, Japan.
G TogoobaatarDepartment of Health Policy, National Center for Child Health and Development, Tokyo, Japan.
G CarroliCentro Rosarino de Estudios Perinatales, Rosario, Argentina.
H KnightRoyal College of Obstetricians and Gynaecologists, Office for Research and Clinical Audit, Lindsay Stewart R&D Centre, London, UK.
J ZhangMinistry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
J G CecattiDepartment of Obstetrics and Gynaecology, School of Medical Sciences, University of Campinas (UNICAMP), Campinas, SP, Brazil.
J P VogelDepartment of Reproductive Health and Research, UNDP-UNFPA-UNICEF-WHO World Bank Special Programme of Research, Development and Research Training in Human Reproduction, WHO, Geneva, Switzerland.
K JayaratneFamily Health Bureau, Ministry of Health, Colombo, Sri Lanka.
M C LealEscola Nacional de Saúde Pública (ENSP), Fundação Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, Brazil.
M GisslerNational Institute for Health and Welfare, Helsinki, Finland.
N MorisakiDepartment of Health Policy, National Center for Child Health and Development, Tokyo, Japan.
N LackBayerische Arbeitsgemeinschaft für Qualitätssicherung in der Stationären Versorgung (BAQ), Bayerische Krankenhausgesellschaft, Munich, Germany.
O T OladapoDepartment of Reproductive Health and Research, UNDP-UNFPA-UNICEF-WHO World Bank Special Programme of Research, Development and Research Training in Human Reproduction, WHO, Geneva, Switzerland.
Ö TunçalpDepartment of Reproductive Health and Research, UNDP-UNFPA-UNICEF-WHO World Bank Special Programme of Research, Development and Research Training in Human Reproduction, WHO, Geneva, Switzerland.
P LumbiganonDepartment of Obstetrics and Gynecology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.
R MoriDepartment of Health Policy, National Center for Child Health and Development, Tokyo, Japan.
S QuintanaDepartment of Gynaecology and Obstetrics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil.
A D Costa PassosDepartment of Social Medicine, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil.
A C MarcolinDepartment of Gynaecology and Obstetrics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil.
A ZongoResearch Institute for Development, Université Paris Descartes, Sorbonne Paris Cité, UMR 216, Paris, France.
B BlondelInserm U1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team, Center for Epidemiology and Biostatistics, Paris Descartes University, Paris, France.
B HernándezInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.
C J HogueDepartment of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
C PrunetInserm U1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team, Center for Epidemiology and Biostatistics, Paris Descartes University, Paris, France.
C LandmanEscola Nacional de Saúde Pública (ENSP), Fundação Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, Brazil.
C OchirSchool of Public Health, Health Sciences University of Mongolia, Ulaanbaatar, Mongolia.
C CuestaCentro Rosarino de Estudios Perinatales, Rosario, Argentina.
C Pileggi-CastroGLIDE Technical Cooperation and Research, Ribeirão Preto, SP, Brazil.
D WalkerDepartments of Obstetrics & Gynaecology and Global Health Sciences, University of California, San Francisco, CA, USA.
D AlvesDepartment of Social Medicine, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil.
E AbalosCentro Rosarino de Estudios Perinatales, Rosario, Argentina.
Ecd MoisesDepartment of Gynaecology and Obstetrics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil.
E M VieiraDepartment of Social Medicine, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil.
G DuarteDepartment of Gynaecology and Obstetrics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil.
G PerdonaDepartment of Social Medicine, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil.
I Gurol-UrganciRoyal College of Obstetricians and Gynaecologists, Office for Research and Clinical Audit, Lindsay Stewart R&D Centre, London, UK.
K TakahikoDepartment of Health Policy, National Center for Child Health and Development, Tokyo, Japan.
L MoscoviciDepartment of Social Medicine, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil.
L CampodonicoCentro Rosarino de Estudios Perinatales, Rosario, Argentina.
L Oliveira-CiabatiDepartment of Social Medicine, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil.
M LaopaiboonDepartment of Biostatistics and Demography, Faculty of Public Health, Khon Kaen University, Khon Kaen, Thailand.
M DanansuriyaFamily Health Bureau, Ministry of Health, Colombo, Sri Lanka.
M Nakamura-PereiraEscola Nacional de Saúde Pública (ENSP), Fundação Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, Brazil.
M L CostaDepartment of Obstetrics and Gynaecology, School of Medical Sciences, University of Campinas (UNICAMP), Campinas, SP, Brazil.
M R TorloniDepartment of Obstetrics, School of Medicine of São Paulo, São Paulo Federal University, São Paulo, Brazil.
M R KramerDepartment of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
P BorgesEscola Nacional de Saúde Pública (ENSP), Fundação Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, Brazil.
P B OlkhanudSchool of Public Health, Health Sciences University of Mongolia, Ulaanbaatar, Mongolia.
R Pérez-CuevasSocial Protection and Health Division, Inter-American Development Bank, Mexico City, Mexico.
S B AgampodiFamily Health Bureau, Ministry of Health, Colombo, Sri Lanka.
S MittalFortis Memorial Research Institute, Gurgaon, Haryana, India.
S SerruyaLatin American Center for Perinatology, Women and Reproductive Health, (CLAP/WR), WHO Regional Office for the Americas, Montevideo, Uruguay.
V BatagliaHospital Nacional de Itauguá, Itauguá, Paraguay.
Z LiFaculty of Health, University of Technology, Sydney, NSW, Australia.
M TemmermanDepartment of Reproductive Health and Research, UNDP-UNFPA-UNICEF-WHO World Bank Special Programme of Research, Development and Research Training in Human Reproduction, WHO, Geneva, Switzerland.
A M GülmezogluDepartment of Reproductive Health and Research, UNDP-UNFPA-UNICEF-WHO World Bank Special Programme of Research, Development and Research Training in Human Reproduction, WHO, Geneva, Switzerland.

Funding

Training in Reproductive, Perinatal, Pediatric EpidemiologyT32HD052460 · NICHD · EMORY UNIVERSITY · PI DREWS-BOTSCH, CAROLYN DAWSON · 2006 to 2015
$2.2M
NICHD NIH HHS T32 HD052460World Health Organization 001
6 · The paper itself

Abstract

objectiveTo generate a global reference for caesarean section (CS) rates at health facilities.

designCross-sectional study.

settingHealth facilities from 43 countries. POPULATION/SAMPLE: Thirty eight thousand three hundred and twenty-four women giving birth from 22 countries for model building and 10,045,875 women giving birth from 43 countries for model testing.

methodsWe hypothesised that mathematical models could determine the relationship between clinical-obstetric characteristics and CS. These models generated probabilities of CS that could be compared with the observed CS rates. We devised a three-step approach to generate the global benchmark of CS rates at health facilities: creation of a multi-country reference population, building mathematical models, and testing these models.

main outcome measuresArea under the ROC curves, diagnostic odds ratio, expected CS rate, observed CS rate.

resultsAccording to the different versions of the model, areas under the ROC curves suggested a good discriminatory capacity of C-Model, with summary estimates ranging from 0.832 to 0.844. The C-Model was able to generate expected CS rates adjusted for the case-mix of the obstetric population. We have also prepared an e-calculator to facilitate use of C-Model (www.who.int/reproductivehealth/publications/maternal_perinatal_health/c-model/en/).

conclusionsThis article describes the development of a global reference for CS rates. Based on maternal characteristics, this tool was able to generate an individualised expected CS rate for health facilities or groups of health facilities. With C-Model, obstetric teams, health system managers, health facilities, health insurance companies, and governments can produce a customised reference CS rate for assessing use (and overuse) of CS. TWEETABLE ABSTRACT: The C-Model provides a customized benchmark for caesarean section rates in health facilities and systems.

Indexed as

Models, StatisticalAdultCesarean SectionCross-Sectional StudiesFemaleHumansInternationalityPregnancyReference ValuesBenchmarkingcaesarean delivery ratescaesarean section rateslogistic regression

Identifiers

PMID26259689
PMCPMC4873961

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.