Observational studyBMC pregnancy and childbirth2025
Cesarean section in Suriname using robson classification: a two-year nationwide cross-sectional study on rates, risk factors and perinatal outcomes of cesarean section.
Observational study in BMC pregnancy and childbirth, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.
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Who cites it
2 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
- [Effects of probiotics combined with breastfeeding on intestinal colonization and the risk of allergic diseases in newborns delivered by cesarean section: a 5-year follow-up study].Zhongguo dang dai er ke za zhi = Chinese journal of contemporary pediatrics · 2026Article
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7 authors.
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Abstract
backgroundOptimizing CS performance is a global health priority, given the maternal and perinatal morbidity and mortality associated with both underuse and overuse. This study aims to (1) determine the facility-based CS rate in Suriname and explore which women are most likely to undergo a CS and (2) classify all CS by the WHO Robson classification and analyze the perinatal outcomes.
methodsAn observational, cross-sectional study in Suriname, using nationwide birth registry data that included all hospital births in 2020 and 2021 (≥ 27 weeks of gestation). We used multivariate logistic regression analysis to assess maternal and perinatal characteristics associated with CS. We described cesarean births according to the Robson-10 classification and used descriptive statistics to analyze CS frequencies and perinatal outcomes.
resultsWe analyzed the 18,917 women who gave birth in Surinamese hospitals, with an overall 23.9% CS rate (n = 4522/18,917). The highest CS rates were seen among women with a previous CS (69.3%, aOR 16.2, 95% CI 14.4-18.2), BMI > 40 (47.0%, aOR 5.1, 95% CI 4.0-6.5), newborn with a birthweight from or above 4,000 g (37.3%, 2.2, 95% CI 1.6-3.0) and women giving birth at hospital IV (38.5%, aOR 1.8, 95% CI 1.6-2.0). Hindustani women were more likely to give birth by CS compared to Maroon women (aOR 1.6, 95% CI 1.4-2.0). The largest contribution to the overall CS rate was Robson group 5 (i.e. multiparous women with a previous CS and a singleton term pregnancy in cephalic presentation, 30.5%, n = 1,378). Robson group 2 and 4 (i.e. pre-labor CS, or CS after induction, among term women without previous CS and cephalic presentation) contributed to 21.8% (n = 985) of all CS performed. Robson group 1 and 3 (i.e. during spontaneous labor CS among term women without previous CS and cephalic presentation) accounted for 23.3% (n = 1,052) of all CS cases.
conclusionThe facility-based CS rate in Suriname is 24%, with substantial intra-country and inter-hospital variations. These disparities underscore the need for targeted interventions addressing both overuse and underuse of CS. Preventative measures should prioritize promoting safe VBAC, increasing assisted vaginal birth, preventing first-time CS and ongoing monitoring of trends and regular case audits.
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