Evidence map›Paper›PMID 41000077›Full record

ArticleO&G open2025

Temporal Trends in Second-Stage Cesarean Birth in Ontario, Canada, 2012-2021.

Vanessa Hébert, Sheryll Dimanlig-Cruz, Giulia M Muraca

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in O&G open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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

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.

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

1 citing paper in PubMed.

  1. Article
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

3 authors.

Vanessa HébertDepartment of Health Research Methods, Evidence and Impact and the Department of Obstetrics and Gynecology, Faculty of Health Sciences, McMaster University, Hamilton, the Better Outcomes Registry & Network (BORN) Ontario, Ottawa, Ontario, Canada; and the Clinical Epidemiology Unit, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden.
Sheryll Dimanlig-CruzDepartment of Health Research Methods, Evidence and Impact and the Department of Obstetrics and Gynecology, Faculty of Health Sciences, McMaster University, Hamilton, the Better Outcomes Registry & Network (BORN) Ontario, Ottawa, Ontario, Canada; and the Clinical Epidemiology Unit, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden.
Giulia M MuracaDepartment of Health Research Methods, Evidence and Impact and the Department of Obstetrics and Gynecology, Faculty of Health Sciences, McMaster University, Hamilton, the Better Outcomes Registry & Network (BORN) Ontario, Ottawa, Ontario, Canada; and the Clinical Epidemiology Unit, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo characterize trends in the mode of delivery in the second stage of labor, to assess factors associated with second-stage cesarean birth compared with operative vaginal birth, and to evaluate the contribution of these factors to changes in second-stage cesarean birth rates over time among individuals giving birth in Ontario, Canada.

methodsThis was a population-based cohort study of all individuals in Ontario, Canada (2012-2021), with singleton term pregnancies reaching full cervical dilation. Temporal trends were assessed with the Cochran-Armitage test. Modified Poisson regression was used to obtain crude (relative risk [RR]) and adjusted relative risk [aRR] and 95% CIs and to quantify the contribution of maternal, obstetric, fetal, and neonatal factors to temporal variations in second-stage cesarean birth rates. All analyses were stratified by parity.

resultsAmong 806,645 births included, 26.7% of nulliparous and 6.5% of parous individuals had a second-stage cesarean birth or an operative vaginal birth, with ratios of cesarean to operative vaginal birth of 0.24 and 0.16, respectively. Between 2012-2013 and 2020-2021, second-stage cesarean birth rates increased from 4.8% to 5.8% for nulliparous individuals (

conclusionBetween 2012 and 2021, second-stage cesarean birth rates and ratios of cesarean to operative vaginal birth increased in Ontario, Canada. Changes in obstetric practices were the primary modifiable drivers of this trend.

Identifiers

PMID41000077
PMCPMC12421972

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LicenceCC BY
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Registered trials

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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.