Evidence map›Paper›PMID 30249198›Full record

ArticleBMC pregnancy and childbirth2018

Vaginal birth after caesarean birth in Italy: variations among areas of residence and hospitals.

Paola Colais, Katia Bontempi, Luigi Pinnarelli, Carlo Piscicelli, Ilenia Mappa, Danilo Fusco, Marina Davoli

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC pregnancy and childbirth, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
1.2field-weighted citation impact, top 19% of its field
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

7 citing papers in PubMed, 12 citations in OpenAlex.

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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

7 authors at 2 institutions in 1 country.

Paola ColaisDepartment of Epidemiology, Lazio Regional Health Service, Via Cristoforo Colombo 112, 00142, Rome, Italy.
Katia BontempiDepartment of Epidemiology, Lazio Regional Health Service, Via Cristoforo Colombo 112, 00142, Rome, Italy.
Luigi PinnarelliDepartment of Epidemiology, Lazio Regional Health Service, Via Cristoforo Colombo 112, 00142, Rome, Italy. l.pinnarelli@deplazio.it.
Carlo PiscicelliCristo Re Hospital, Via delle Calasanziane, 25, 00167, Rome, Italy.
Ilenia MappaCristo Re Hospital, Via delle Calasanziane, 25, 00167, Rome, Italy.
Danilo FuscoDepartment of Epidemiology, Lazio Regional Health Service, Via Cristoforo Colombo 112, 00142, Rome, Italy.
Marina DavoliDepartment of Epidemiology, Lazio Regional Health Service, Via Cristoforo Colombo 112, 00142, Rome, Italy.
Agenzia Regionale Parchi · ITOspedale Cristo Re · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe rates of caesarean section (CS) are increasing globally. CS rates are one of the most frequently used indicators of health care quality. Vaginal Birth After Caesarean (VBAC) could be considered a reasonable and safe option for most women with a previous CS. Despite this fact, in some European countries, many women who had a previous CS will have a routine CS subsequently and VBAC rates are extremely variable across countries. VBAC use is inversely related to caesarean use. The objective of the present study was to analyze VBAC rates with respect to caesarean rates and the variations among areas of residence, hospitals and hospital ownership types in Italy.

methodsThis study was based on information from the Hospital Information System (HIS). We collected data from all deliveries in Italy from January 1, 2010 to December 31, 2014 and we considered only deliveries with a previous caesarean section. Applying multivariate logistic regression analysis, the adjusted proportions of VBAC for each Local Health Units (LHU), each hospital and by hospital ownership types were calculated. Cross-classified logistic multilevel models were performed to analyze within geographic, hospitals and hospital ownership types variations.

resultsWe studied a total of 77,850 deliveries with a previous caesarean section in Italy between January 1, 2010 and December 31, 2014. The proportion of VBAC in Italy slightly increased in the last few years, from 5.8% in 2010 to 7.5% in 2014. Proportions of VBAC ranged from 0.29 to 50.05% in Italian LHUs. The LHUs with lower proportions of VBAC deliveries were characterized by higher values for primary caesarean deliveries. Private hospitals showed the lowest mean of crude VBAC proportions but the highest variation among hospitals, ranging from 0 to 47.1%.

conclusionsHospital rates of caesarean section for women with at least one previous caesarean section vary widely, and only some of the variation can be explained by case-mix and hospital-level factors, suggesting that additional factors influence practices. Identifying disparities in VBAC may have important implications for health services planning and targeted efforts to reduce overall rates of caesarean deliveries.

Indexed as

AdultCesarean SectionCesarean Section, RepeatFemaleHospitals, MaternityHumansInfant, NewbornItalyLabor, ObstetricParturitionPregnancyResidence CharacteristicsTrial of LaborVaginal Birth after CesareanYoung AdultCaesarean sectionHealth information systemsHospital careVBAC

Identifiers

PMID30249198
PMCPMC6154898
OpenAlexW2890352341

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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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.