ArticleActa obstetricia et gynecologica Scandinavica2017
A prospective study of maternal, fetal and neonatal outcomes in the setting of cesarean section in low- and middle-income countries.
Article in Acta obstetricia et gynecologica Scandinavica, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 46 papers, 2 of them syntheses that pooled it.
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Who cites it
46 citing papers in PubMed, 2 syntheses or guidelines pooled it, 84 citations in OpenAlex.
- Preference of mode of delivery and associated factors among mothers in East Africa: systematic review and meta-analysis.BMC pregnancy and childbirth · 2025Pooled it
- Risk factors for postpartum maternal mortality and hospital readmission in low- and middle-income countries: a systematic review.BMC pregnancy and childbirth · 2023Pooled it
- Trial
- Delivery outcomes in women with previous caesarean delivery at Zithulele Hospital - A rural district hospital managed by generalist doctors.South African family practice : official journal of the South African Academy of Family Practice/Primary Care · 2026Article
- Article
- Facilitators and barriers to implementation of obstetric ultrasound scanning intervention by midwives within maternal and child health departments of the selected healthcare facilities in four districts of Zambia: experiences of healthcare workers.BMC pregnancy and childbirth · 2026Article
- Epidemiology and determinants of stillbirth disparities in India: a geospatial hotspot clustering study using integrated population-level data.The Lancet regional health. Southeast Asia · 2025Article
- Mandatory second opinion to reduce caesarean section rate among low-risk pregnant women at a private tertiary hospital, a pre and post intervention study: an analysis using WHO Robson classification.BMC pregnancy and childbirth · 2025Article
- Mode of delivery and its influences on neonatal morbidity among newly born babies at maternity teaching hospitals in Mosul City: A comparison study.Journal of education and health promotion · 2025Article
- Trends and determinants of the use of episiotomy in a prospective population-based registry from central India.BMC pregnancy and childbirth · 2024Article
- Risk factors for postpartum readmission: a prediction model in Iranian pregnant women.BMC pregnancy and childbirth · 2024Article
- Caesarean section delivery rates and associated factors in a faith-based referral hospital in Ghana: A retrospective analysis.PloS one · 2024Article
- Proportion and associated factors of maternal complications of cesarean sections among mothers who deliver at Bahir Dar City Public Specialized Hospitals, Bahir Dar, Ethiopia.BMC women's health · 2023Article
- Maternal Mortality in a Rural District of Pakistan and Contributing Factors.Maternal and child health journal · 2023Article
- Prediction of Emergency Cesarean Section Using Detectable Maternal and Fetal Characteristics Among Saudi Women.International journal of women's health · 2023Article
- Are Primary Health Care Features Associated with Reduced Late Neonatal Mortality in Brazil? An Ecological Study.Maternal and child health journal · 2022Article
- Stillbirth, neonatal and maternal mortality among caesarean births in Kenya and Uganda: a register-based prospective cohort study.BMJ open · 2022Article
- Optimizing availability of obstetric surgical care in India: A cost-effectiveness analysis examining rates and access to Cesarean sections.PLOS global public health · 2022Article
- A mobile cesarean birth center as a solution to improve access to surgical birth in rural Ethiopia: a mixed methods research protocol.Pilot and feasibility studies · 2021Article
- Inequalities in access to birth by caesarean section in the context of user fee exemption for maternal health services in southwest and north central Nigeria.International health · 2021Article
Corrections and comments
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Authors and funding
26 authors at 17 institutions in 8 countries.
Funding
Abstract
introductionCesarean section (CS) rates are increasing globally with an unclear effect on pregnancy outcomes. The study objective was to quantify maternal and perinatal morbidity and mortality associated with CS compared with vaginal delivery (VD) both within and across sites in low- and middle-income countries. MATERIAL AND
methodsA prospective population-based study including home and facility births in 337 153 women with a VD and 47 308 women with a CS from 2010 to 2015 was performed in Guatemala, India, Kenya, Pakistan, Zambia and Democratic Republic of Congo. Women were enrolled during pregnancy; delivery and 6-week follow-up data were collected.
resultsAcross all sites, CS rates increased from 8.6% to 15.2%, but remained low in African sites. Younger, nulliparous women were more likely to have a CS, as were women with higher education and those delivering an infant weighing 1500-2499 g. Across all sites, maternal and neonatal mortality was higher, and stillbirths were lower, in pregnancies delivered by CS. Antepartum and postpartum complications as well as obstetric interventions and treatments were more common among women who underwent CS. In stratified analyses, all outcomes were worse in women with a CS compared with VD in African compared to non-African sites.
conclusionsCS rates increased across all sites during the study period, but at more pronounced rates in the non-African sites. CS was associated with reduced postpartum hemorrhage and lower rates of stillbirths in the non-African sites. In the African sites, CS was associated with an increase in all adverse outcomes. Further studies are necessary to better understand the increase in adverse outcomes with CS in the African sites.
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