Trial reportPloS one2018
Cesarean delivery rate and staffing levels of the maternity unit.
Trial report in PloS one, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 3 of them syntheses that pooled it.
What it found
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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.
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.
Who cites it
20 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Variation in caesarean section rates according to the Robson classification in four low- and middle-income countries: a meta-analysis of groups 1 to 4.BMC pregnancy and childbirth · 2025Pooled it
- Pooled it
- Caesarean sections in teaching hospitals: systematic review and meta-analysis of hospitals in 22 countries.BMJ open · 2021Pooled it
- Hospital Variation in Labor After Cesarean and Vaginal Birth After Cesarean in Massachusetts, 2012-2022.O&G open · 2026Article
- Facility-Level Factors Associating Antenatal Corticosteroid Administration Rates and Subsequent Term Birth Rates: A Nationwide Cross-Sectional Observational Study Using the 2020-2022 Perinatal Registry Database in Japan.The journal of obstetrics and gynaecology research · 2026Observational
- Dynamic machine learning models for predicting cesarean delivery risk in women with no prior cesarean delivery: A retrospective nationwide cohort analysis.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2025Article
- Exploring the influence of medical staffing and birth volume on observed-to-expected cesarean deliveries: a panel data analysis of integrated obstetric and gynecological departments in Germany.The European journal of health economics : HEPAC : health economics in prevention and care · 2025Article
- Capacity Planning (Capital, Staff and Costs) of Inpatient Maternity Services: Pitfalls for the Unwary.International journal of environmental research and public health · 2025Article
- Article
- Mode of delivery and behavioral and neuropsychological outcomes in children at 10 years of age.Journal of perinatal medicine · 2024Article
- Staff Resources in Public and Private Hospitals and Their Implication for Medical Practice: A French Study of Caesareans.Healthcare (Basel, Switzerland) · 2024Article
- Article
- How does hospital organisation influence the use of caesarean sections in low- and middle-income countries? A cross-sectional survey in Argentina, Burkina Faso, Thailand and Vietnam for the QUALI-DEC project.BMC pregnancy and childbirth · 2024Article
- Investing in midwifery for sustainable development goals in low- and middle-income countries: a cost-benefit analysis.Cost effectiveness and resource allocation : C/E · 2024Article
- Spatial distribution of caesarean deliveries and their determinants in Bangladesh: evidence from linked data of population and health facility survey.The Lancet regional health. Southeast Asia · 2023Article
- Comparison of two methods of complementary medicine on postoperative pain and anxiety: A randomized clinical trial.Journal of education and health promotion · 2023Article
- Office hours and caesarean section: systematic review and Meta-analysis.Research in health services & regions · 2022Review
- Accurate prediction of birth implementing a statistical model through the determination of steroid hormones in saliva.Scientific reports · 2021Article
- Multilevel analysis of birthplace effect on the proportion of C-Section in Colombia".Colombia medica (Cali, Colombia)Article
- Modelling the Number of People per Physician, Nurse, and Midwives in Turkey in Terms of Reproductive Health Indicators.Inquiry : a journal of medical care organization, provision and financingArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo investigate whether staffing levels of maternity units affect prelabor urgent, elective, and intrapartum cesarean delivery rates.
methodsThis population-based retrospective cohort study covers the deliveries of the 11 hospitals of a French perinatal network in 2008-2014 (N = 102 236). The independent variables were women's demographic and medical characteristics as well as the type, organization, and staffing levels for obstetricians, anesthesiologists, and midwives of each maternity unit. Bivariate and multivariate analyses were conducted with multilevel logistic models.
resultsOverall, 23.9% of the women had cesarean deliveries (2.4% urgent before labor, 10% elective, and 11.5% intrapartum). Independently of individual- and hospital-level factors, the level of obstetricians, measured by the number of full-time equivalent persons (i.e., 35 working hours per week) per 100 deliveries, was negatively associated with intrapartum cesarean delivery (adjusted odds ratio, aOR 0.55, 95% confidence interval, CI 0.36-0.83, P-value = 0.005), and the level of midwives negatively associated with elective cesarean delivery (aOR 0.79, 95% CI 0.69-0.90, P-value < 0.001). Accordingly, a 10% increase in obstetrician and midwife staff levels, respectively, would have been associated with a decrease in the likelihood of intrapartum cesarean delivery by 2.5 percentage points and that of elective cesarean delivery by 3.4 percentage points. These changes represent decreases in intrapartum and elective cesarean delivery rates of 19% (from 13.1% to 10.6%) and 33% (from 10.3% to 6.9%), respectively.
conclusionStaffing levels of maternity units affect the use of cesarean deliveries. High staffing levels for obstetricians and midwives are associated with lower cesarean rates.
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