Evidence map›Paper›PMID 28166782›Full record

ArticleBMC pregnancy and childbirth2017

Caesarean deliveries in China.

Xin Wang, Susan Hellerstein, Lei Hou, Liying Zou, Yan Ruan, Weiyuan Zhang

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Article in BMC pregnancy and childbirth, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
27citing papers in PubMed, 3 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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

27 citing papers in PubMed, 3 syntheses or guidelines pooled it.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Xin WangDepartment of Obstetrics, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, No. 251 YaoJiayuan Road, Chaoyang District, Beijing, 100026, China.
Susan HellersteinDepartment of Obstetrics and Gynecology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, 01210, USA.
Lei HouDepartment of Obstetrics, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, No. 251 YaoJiayuan Road, Chaoyang District, Beijing, 100026, China.
Liying ZouDepartment of Obstetrics, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, No. 251 YaoJiayuan Road, Chaoyang District, Beijing, 100026, China.
Yan RuanDepartment of Obstetrics, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, No. 251 YaoJiayuan Road, Chaoyang District, Beijing, 100026, China.
Weiyuan ZhangDepartment of Obstetrics, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, No. 251 YaoJiayuan Road, Chaoyang District, Beijing, 100026, China. zhangwy9921@hotmail.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe caesarean section rate has risen rapidly in China. The purpose of this retrospective study was to estimate caesarean section rates and indications by hospital facility level in Mainland China to investigate reasons contributing to the high rate.

methodsThis cross-sectional hospital-based study collected data from 39 hospitals in three geographical regions in China, covering 14 different provinces, municipalities, and autonomous regions, including 20 tertiary health hospitals and 19 secondary hospitals. Data from all women who gave birth at these hospitals during 2011 were included.

resultsA total of 112,138 women who gave birth after 24 weeks of gestation were surveyed. Of these pregnancies, 54.5% (61,084 cases) resulted in caesarean section, non-indicated caesarean section accounted for 38.4% of caesarean sections. Overall caesarean section rates were higher at the tertiary level hospitals (55.9%) compared to the secondary level hospitals (50.9%). The secondary level hospitals had higher rates of non-indicated caesarean section (48.9% of caesarean sections) compared to tertiary level hospitals (34.5% of caesarean sections). The rate of caesarean section on maternal request was higher in the secondary hospitals (16.6%) than in the tertiary hospitals (10%) (P < 0.001), as well as the caesarean section rate for CPD prior to labour. Operative vaginal deliveries were overall rare (1.2%) with 90.9% (1200/1320 cases) performed in the tertiary hospitals.

conclusionsCaesarean section on maternal request accounts for a large portion of China's high caesarean section rate, especially in the secondary hospitals. The first step to reduced caesarean section rates is to decrease the number of non-indicated caesarean sections.

Indexed as

AdultCesarean SectionChinaCross-Sectional StudiesDelivery, ObstetricFemaleHospitalsHumansPregnancyRetrospective StudiesUnnecessary ProceduresYoung AdultCaesarean sectionIndicationSecondary level hospitalTertiary level hospital

Identifiers

PMID28166782
PMCPMC5294866

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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.