Observational studyBMC pregnancy and childbirth2021
Using the Robson classification to assess caesarean section rates in Brazil: an observational study of more than 24 million births from 2011 to 2017.
Observational study in BMC pregnancy and childbirth, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.
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Who cites it
15 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Primary cesarean section in Sub-Saharan Africa: A systematic review and meta-analysis using the Robson Ten-Group Classification System.PloS one · 2026Pooled it
- Scientific production on health inequalities using the Brazilian Information System on Live Births: a scoping review.Cadernos de saude publica · 2026Article
- Post-term births as a risk factor for small for gestational age births and infant mortality in Brazil, Mexico, and Palestinian refugees: An analysis of electronic birth records.Paediatric and perinatal epidemiology · 2025Article
- Recent temporal trends in cesarean section rates in Brazil according to the Robson classification system.Cadernos de saude publica · 2025Article
- Article
- Maternal health surveillance panel: a tool for expanding epidemiological surveillance of women's health and its determinants.Revista brasileira de epidemiologia = Brazilian journal of epidemiology · 2024Article
- Trends in cesarean section rates in Brazil by Robson classification group, 2014-2020.Revista brasileira de enfermagem · 2024Article
- [Classification of caesarean sections by 10 Robson groups in a second level hospital].Revista medica del Instituto Mexicano del Seguro Social · 2023Observational
- The impact of maternal morbidity on cesarean section rates: exploring a Latin American network of sentinel facilities using the Robson's Ten Group Classification System.BMC pregnancy and childbirth · 2023Article
- Cesarean sections and early-term births according to Robson classification: a population-based study with more than 17 million births in Brazil.BMC pregnancy and childbirth · 2023Article
- Achievement of appropriate cesarean rates using Robson's 10-Group classification system in Brazilian private practice.BMC pregnancy and childbirth · 2023Article
- Cesarean section rates according to the Robson Classification and its association with adequacy levels of prenatal care: a cross-sectional hospital-based study in Brazil.BMC pregnancy and childbirth · 2023Article
- Mucinous Cystadenoma Arising in a Uterine Isthmocele: A Case Report.Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia · 2023Article
- Implementation of the Robson Classification in Greece: A Retrospective Cross-Sectional Study.Healthcare (Basel, Switzerland) · 2023Article
- Cesarean section in Uruguay from 2008 to 2018: country analysis based on the Robson classification. An observational study.BMC pregnancy and childbirth · 2022Observational
Corrections and comments
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Authors and funding
9 authors.
Funding
Abstract
backgroundApplying the Robson classification to all births in Brazil, the objectives of our study were to estimate the rates of caesarean section delivery, assess the extent to which caesarean sections were clinically indicated, and identify variation across socioeconomic groups.
methodsWe conducted a population-based study using routine records of the Live Births Information System in Brazil from January 1, 2011, to December 31, 2017. We calculated the relative size of each Robson group; the caesarean section rate; and the contribution to the overall caesarean section rate. We categorised Brazilian municipalities using the Human Development Index to explore caesarean section rates further. We estimated the time trend in caesarean section rates.
resultsThe rate of caesarean sections was higher in older and more educated women. Prelabour caesarean sections accounted for more than 54 % of all caesarean deliveries. Women with a previous caesarean section (Group 5) made up the largest group (21.7 %). Groups 6-9, for whom caesarean sections would be indicated in most cases, all had caesarean section rates above 82 %, as did Group 5. The caesarean section rates were higher in municipalities with a higher HDI. The general Brazilian caesarean section rate remained stable during the study period.
conclusionsBrazil is a country with one of the world's highest caesarean section rates. This nationwide population-based study provides the evidence needed to inform efforts to improve the provision of clinically indicated caesarean sections. Our results showed that caesarean section rates were lower among lower socioeconomic groups even when clinically indicated, suggesting sub-optimal access to surgical care.
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