Observational studyBJOG : an international journal of obstetrics and gynaecology2021
Using Robson's Ten-Group Classification System for comparing caesarean section rates in Europe: an analysis of routine data from the Euro-Peristat study.
Observational study in BJOG : an international journal of obstetrics and gynaecology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 22 papers.
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Who cites it
22 citing papers in PubMed.
- Dynamic and heterogeneous impacts of granting and revoking elective c-section rights in São Paulo.Health policy and planning · 2026Article
- Implementation of the Robson classification for caesarean sections in Israel: a 10-year cross-sectional study.Israel journal of health policy research · 2025Article
- Effects of fetal presentation on mode of delivery in 26 143 twin pregnancies: A nationwide, population-based observational study of 31-year real-world data.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2025Observational
- Reaching caesarean section rates below 15%: experience of a French tertiary maternity using the Robson classification system.Reproductive health · 2025Observational
- A Retrospective Analysis of the Robson Classification Implementation in a Tertiary Care Hospital in Serbia.Journal of clinical medicine · 2025Article
- Cross-sectional analysis of caesarean sections according to the Robson 10-group classification system in Somalia.BMJ open · 2025Article
- Cesarean section trends from 1992 to 2023 in Estonia among singleton term pregnancies: A registry-based study.European journal of midwifery · 2025Article
- If the first child is breech, overall outcomes for families with two children are similar regardless of the mode of the first birth.Scientific reports · 2024Article
- Optimizing caesarean section use and feasibility of implementing the Robson classification system: Perspectives of healthcare providers and policymakers.SAGE open medicine · 2024Article
- Cesarean section trends from 1992 to 2016 in Estonia and Finland: A registry-based study.Acta obstetricia et gynecologica Scandinavica · 2023Article
- Frequency of Caesarean Section Classified by Robson's Ten Group Classification System: A Scoping Review.Cureus · 2023Article
- Indications of Induction and Caesarean Sections Performed Using the Robson Classification in a University Hospital in Spain from 2010 to 2021.Healthcare (Basel, Switzerland) · 2023Article
- Article
- Corrigendum.BJOG : an international journal of obstetrics and gynaecology · 2022Article
- Crude and adjusted comparisons of cesarean delivery rates using the Robson classification: A population-based cohort study in Canada and Sweden, 2004 to 2016.PLoS medicine · 2022Article
- A step towards better audit: The Robson Ten Group classification system for outcomes other than cesarean section.Acta obstetricia et gynecologica Scandinavica · 2022Article
- The duration of spontaneous active and pushing phases of labour among 75,243 US women when intervention is minimal: A prospective, observational cohort study.EClinicalMedicine · 2022Article
- Use of induction of labour and emergency caesarean section and perinatal outcomes in English maternity services: a national hospital-level study.BJOG : an international journal of obstetrics and gynaecology · 2022Article
- How can we attain enhanced quality assurance of the mode of birth?European journal of midwifery · 2022Article
- Giving birth: A hermeneutic study of the expectations and experiences of healthy primigravid women in Switzerland.PloS one · 2022Article
Corrections and comments
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- Erratum issuedCorrigendum.2022
Authors and funding
12 authors.
Funding
Abstract
objectiveRobson's Ten Group Classification System (TGCS) creates clinically relevant sub-groups for monitoring caesarean birth rates. This study assesses whether this classification can be derived from routine data in Europe and uses it to analyse national caesarean rates.
designObservational study using routine data.
settingTwenty-seven EU member states plus Iceland, Norway, Switzerland and the UK. POPULATION: All births at ≥22 weeks of gestational age in 2015.
methodsNational statistical offices and medical birth registers derived numbers of caesarean births in TGCS groups.
main outcome measuresOverall caesarean rate, prevalence and caesarean rates in each of the TGCS groups.
resultsOf 31 countries, 18 were able to provide data on the TGCS groups, with UK data available only from Northern Ireland. Caesarean birth rates ranged from 16.1 to 56.9%. Countries providing TGCS data had lower caesarean rates than countries without data (25.8% versus 32.9%, P = 0.04). Countries with higher caesarean rates tended to have higher rates in all TGCS groups. Substantial heterogeneity was observed, however, especially for groups 5 (previous caesarean section), 6, 7 (nulliparous/multiparous breech) and 10 (singleton cephalic preterm). The differences in percentages of abnormal lies, group 9, illustrate potential misclassification arising from unstandardised definitions.
conclusionsAlthough further validation of data quality is needed, using TGCS in Europe provides valuable comparator and baseline data for benchmarking and surveillance. Higher caesarean rates in countries unable to construct the TGCS suggest that effective routine information systems may be an indicator of a country's investment in implementing evidence-based caesarean policies. TWEETABLE ABSTRACT: Many European countries can provide Robson's Ten-Group Classification to improve caesarean rate comparisons.
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