Evidence map›Paper›PMID 36461037›Full record

ArticleBMC pregnancy and childbirth2022

Exploring the impact of indication on variation in rates of intrapartum caesarean section in six Palestinian hospitals: a prospective cohort study.

Mohammed W Zimmo, Katariina Laine, Sahar Hassan, Bettina Bottcher, Erik Fosse, Hadil Ali-Masri, Khaled Zimmo, Ragnhild Sørum Falk, Marit Lieng, Ase Vikanes

Registry-linked trialOpen access · goldAbstract read
In one paragraph

Article in BMC pregnancy and childbirth, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02427854 (Can Perineal Tears and Obstetric Anal Sphincter Injuries in Palestine be Prevented? A Study of Two Different Interventions), which is not on this map. Not yet cited in PubMed.

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0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact, top 78% 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.

NCT02427854 nacompletednot on this map

Can Perineal Tears and Obstetric Anal Sphincter Injuries in Palestine be Prevented? A Study of Two Different Interventions

TypeinterventionalSponsorOslo University HospitalRan2015 to 2018Enrolled51,041ConditionsComplication of Labor and DeliveryArmsEducation by animated training video, Interactive hands-on bedside training
3 · Its place in the literature

Who cites it

0 citing papers in PubMed, 0 citations in OpenAlex.

No citing paper in PubMed yet.

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

10 authors at 3 institutions in 2 countries.

Mohammed W ZimmoFaculty of Medicine, Institute for Clinical Medicine, University of Oslo, Oslo, Norway. mohammedzimmo1983@gmail.com.ORCID http://orcid.org/0000-0002-0177-4521
Katariina LaineInstitute for Clinical Medicine, University of Oslo, Oslo, Norway.
Sahar HassanFaculty of Nursing, Pharmacy and Health Professions and Institute of Community and Public Health, Birzeit University, Ramallah, Palestine.
Bettina BottcherFaculty of Medicine, Islamic University of Gaza, Gaza, Palestine.
Erik FosseThe Intervention Centre, Oslo University Hospital, Oslo, Norway.
Hadil Ali-MasriIntervention Centre, Oslo University Hospital Rikshospitalet, Oslo, Norway.
Khaled ZimmoThe Intervention Centre, Oslo University Hospital, Oslo, Norway.
Ragnhild Sørum FalkOslo Centre for Biostatistics and Epidemiology, Research Support Services, Oslo University Hospital, Oslo, Norway.
Marit LiengInstitute for Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.
Ase VikanesThe Intervention Centre, Oslo University Hospital, Oslo, Norway.
Oslo University Hospital · NOBirzeit University · PSIslamic University of Gaza · PS

Funding

Norwegian Research Council 234452/14
6 · The paper itself

Abstract

backgroundCaesarean section rates are rising globally. No specific caesarian section rate at either country-level or hospital-level was recommended. In Palestinian government hospitals, nearly one-fourth of all births were caesarean sections, ranging from 14.5 to 35.6%. Our aim was to assess whether variation in odds for intrapartum caesarean section in six Palestinian government hospitals can be explained by differences in indications.

methodsData on maternal and fetal health were collected prospectively for all women scheduled for vaginal delivery during the period from 1st March 2015 to 30th November 2016 in six government hospitals in Palestine. Comparisons of proportions in sociodemographic, antenatal obstetric characteristics and indications by the hospital were tested by χ2 test and differences in means by one-way ANOVA analysis. The odds for intrapartum caesarean section were estimated by logistic regression. The amount of explained variance was estimated by Nagelkerke R square.

resultsOut of 51,041 women, 4724 (9.3%) underwent intrapartum caesarean section. The prevalence of intrapartum caesarean section varied across hospitals; from 7.6 to 22.1% in nulliparous, and from 5.8 to 14.1% among parous women. The most common indications were fetal distress and failure to progress in nulliparous, and previous caesarean section with an additional obstetric indication among parous women. Adjusted ORs for intrapartum caesarean section among nulliparous women ranged from 0.42 (95% CI 0.31 to 0.57) to 2.41 (95% CI 1.70 to 3.40) compared to the reference hospital, and from 0.50 (95% CI 0.40-0.63) to 2.07 (95% CI 1.61 to 2.67) among parous women. Indications explained 58 and 66% of the variation in intrapartum caesarean section among nulliparous and parous women, respectively.

conclusionThe differences in odds for intrapartum caesarean section among hospitals could not be fully explained by differences in indications. Further investigations on provider related factors as well as maternal and fetal outcomes in different hospitals are necessary.

Indexed as

ArabsCesarean SectionFemaleHospitals, PublicHumansParturitionPregnancyProspective StudiesCaesarean sectionGazaIndicationsIntrapartumOddsPalestineWest Bank

Identifiers

PMID36461037
PMCPMC9716767
OpenAlexW4311103819

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Registered trials

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.