ArticleBMJ open2018
Risk factors and between-hospital variation of caesarean section in Denmark: a cohort study.
Article in BMJ open, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed.
- Emotional factors, medical interventions and mode of birth among low-risk primiparous women in Poland.Evolution, medicine, and public health · 2023Article
- Exploring the impact of indication on variation in rates of intrapartum caesarean section in six Palestinian hospitals: a prospective cohort study.BMC pregnancy and childbirth · 2022Article
- Child-Mother Index: a new risk factor for selected adverse maternal birth outcomes.AJOG global reports · 2022Article
- Vaginal Birth at Term - Part 1. Guideline of the DGGG, OEGGG and SGGG (S3-Level, AWMF Registry No. 015/083, December 2020).Geburtshilfe und Frauenheilkunde · 2022Article
- Outcomes of induction versus spontaneous onset of labour at 40 and 41 GW: findings from a prospective database, Sri Lanka.BMC pregnancy and childbirth · 2022Article
- Office hours and caesarean section: systematic review and Meta-analysis.Research in health services & regions · 2022Review
- Variation in use of Caesarean section in Norway: An application of spatio-temporal Gaussian random fields.Scandinavian journal of public health · 2021Article
- Could Subtle Obstetrical Brachial Plexus Palsy Be Related to Unilateral B Glenoid Osteoarthritis?Journal of clinical medicine · 2021Article
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesThe aim of this study was to estimate the effects of risk factors on elective and emergency caesarean section (CS) and to estimate the between-hospital variation of risk-adjusted CS proportions.
designHistorical registry-based cohort study. SETTINGS AND
participantsThe study was based on all singleton deliveries in hospital units in Denmark from January 2009 to December 2012. A total of 226 612 births by 198 590 mothers in 29 maternity units were included. PRIMARY AND SECONDARY OUTCOME MEASURES: We estimated (1) OR of elective and emergency CS adjusted for several risk factors, for example, body mass index, parity, age and size of maternity unit and (2) risk-adjusted proportions of elective and emergency CS to evaluate between-hospital variation.
resultsThe CS proportion was stable at 20%-21%, but showed wide variation between units, even in adjusted models. Large units performed significantly more elective CSs than smaller units, and the risk of emergency CS was significantly reduced compared with smaller units. Many of the included risk factors were found to influence the risk of CS. The most important risk factors were breech presentation and previous CS. Four units performed more CSs and one unit fewer CSs than expected.
conclusionThe main risk factors for elective CS were breech presentation and previous CS; for emergency CS they were breech presentation and cephalopelvic disproportion. The proportions of CS were stable during the study period. We found variation in risk-adjusted CS between hospitals in Denmark. Although exhaustive models were applied, the results indicated the presence of systematic variation between hospital units, which was unexpected in a small, well-regulated country such as Denmark.
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