Evidence map›Paper›PMID 37827732›Full record

ArticleBMJ open2023

Epidemiology of emergency and elective caesarean section and its association with early neonatal mortality in sub-Saharan African countries.

Arsène Brunelle Sandie, Martin K Mutua, Estelle Sidze, Vivian Nyakangi, El Hadji Malick Sylla, Anthony Wanjoya, Anne Esther Njom Nlend, Cheikh Faye

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Article in BMJ open, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
–field-weighted citation impact
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

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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

8 citing papers in PubMed.

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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

8 authors.

Arsène Brunelle SandieWest Africa Regional Office, African Population and Health Research Center, Dakar, Senegal asandie@aphrc.org.ORCID 0000-0001-5615-3127
Martin K MutuaWest Africa Regional Office, African Population and Health Research Center, Dakar, Senegal.
Estelle SidzeSexual Reproductive, Maternal, Newborn and Child health Research, African Population and Health Research Center, Nairobi, Senegal.
Vivian NyakangiKenya Country Office, UNICEF, Nairobi, Kenya.
El Hadji Malick SyllaWest Africa Regional Office, African Population and Health Research Center, Dakar, Senegal.ORCID 0000-0003-1634-4708
Anthony WanjoyaDepartment of Statistics and Acturial Sciences, Jomo Kenyatta University of Agriculture and Technology, Nairobi, Kenya.
Anne Esther Njom NlendHopital de la Caisse Nationale de Prevoyance Sociale, Ministere de la Sante Publique, Yaoundé, Cameroon.
Cheikh FayeWest Africa Regional Office, African Population and Health Research Center, Dakar, Senegal.ORCID 0000-0002-4028-0575

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionInvestigating elective and emergency caesarean section (CS) separately is important for a better understanding of birth delivery modes in the sub-Saharan Africa (SSA) region and identifying bottlenecks that prevent favourable childbirth outcomes in SSA. This study aimed at evaluating the prevalences of both CS types, determining their associated socioeconomic factors and their association with early neonatal mortality in SSA.

methodsSSA countries Demographic and Health Surveys data that had collected information on the CS' timing were included in our study. A total of 21 countries were included in this study, with a total of 155 172 institutional live births. Prevalences of both CS types were estimated at the countries' level using household sampling weights. Multilevel models were fitted to identify associated socioeconomic factors of both CS types and their associations with early neonatal mortality.

resultsThe emergency CS prevalence in SSA countries was estimated at 4.6% (95% CI 4.4-4.7) and was higher than the elective CS prevalence estimated at 3.4% (95% CI 3.3-3.6). Private health facilities' elective CS prevalence was estimated at 10.2% (95% CI 9.3-11.2) which was higher than the emergency CS prevalence estimated at 7.7% (95% CI 7.0-8.5). Conversely, in public health facilities, the emergency CS prevalence was estimated at 4.0% (95% CI 3.8-4.2) was higher than the elective CS prevalence estimated at 2.7% (95% CI 2.6-2.8). The richest women were more likely to have birth delivery by both CS types than normal vaginal delivery. Emergency CS was positively associated with early neonatal mortality (adjusted OR=2.37, 95% CI 1.64-3.41), while no association was found with elective CS.

conclusionsFindings suggest shortcomings in pregnancy monitoring, delivery preparation and postnatal care. Beyond antenatal care (ANC) coverage, more attention should be put on quality of ANC, postnatal care, emergency obstetric and newborn care for favourable birth delivery outcomes in SSA.

Indexed as

Cesarean SectionPerinatal DeathAfrica South of the SaharaFemaleHumansInfant MortalityInfant, NewbornLive BirthPregnancyPrevalenceHealth policyMaternal medicineNeonatal intensive & critical careNEONATOLOGYPUBLIC HEALTHReproductive medicine

Identifiers

PMID37827732
PMCPMC10582852

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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.