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  • We studied differences and patterns in cesarean delivery rates by multiplicity and gestational age in Europe and the United States. Methods: This study used routine aggregate data from 17 European countries and the United States on the number of singleton and multiple live births with cesarean versus vaginal delivery by week of gestation in 2008. Overall and gestation-specific cesarean delivery rates were analyzed. We computed rate differences to compare mode of delivery (cesarean vs vaginal birth) between selected gestational age groups and studied associations between rates in these subgroups namely: very preterm (26-31 weeks GA), moderate preterm (32-36 weeks GA), near term (37-38 weeks GA), term (39-41 weeks GA) and post-term (42+ weeks GA) births, using Spearman's rank tests. Results: High variations in cesarean rates for singletons and multiples were observed everywhere. Rates for singletons varied from 15% in The Netherlands and Slovenia, to over 30% in the US and Germany. In singletons, rates were highest for very preterm births and declined to a nadir at 40 weeks of gestation, ranging from 8.0% in Sweden and Norway, to 22.5% in the US. These patterns differed across countries; the average rate difference between very preterm and term births was 43 percentage points, but ranged from 14% to 61%. High variations in rate differences were also observed for near term versus term births. For multiples, rates declined by gestational age in some countries, whereas in others rates were similar across all weeks of gestation. Countries' overall cesarean rates were highly correlated with gestation-specific subgroup rates, except for very preterm births. Conclusions: Gestational age patterns in cesarean delivery were heterogeneous across countries; these differences highlight areas where consensus on best practices is lacking and could be used in developing strategies to reduce cesareans.
  • We studied differences and patterns in cesarean delivery rates by multiplicity and gestational age in Europe and the United States. Methods: This study used routine aggregate data from 17 European countries and the United States on the number of singleton and multiple live births with cesarean versus vaginal delivery by week of gestation in 2008. Overall and gestation-specific cesarean delivery rates were analyzed. We computed rate differences to compare mode of delivery (cesarean vs vaginal birth) between selected gestational age groups and studied associations between rates in these subgroups namely: very preterm (26-31 weeks GA), moderate preterm (32-36 weeks GA), near term (37-38 weeks GA), term (39-41 weeks GA) and post-term (42+ weeks GA) births, using Spearman's rank tests. Results: High variations in cesarean rates for singletons and multiples were observed everywhere. Rates for singletons varied from 15% in The Netherlands and Slovenia, to over 30% in the US and Germany. In singletons, rates were highest for very preterm births and declined to a nadir at 40 weeks of gestation, ranging from 8.0% in Sweden and Norway, to 22.5% in the US. These patterns differed across countries; the average rate difference between very preterm and term births was 43 percentage points, but ranged from 14% to 61%. High variations in rate differences were also observed for near term versus term births. For multiples, rates declined by gestational age in some countries, whereas in others rates were similar across all weeks of gestation. Countries' overall cesarean rates were highly correlated with gestation-specific subgroup rates, except for very preterm births. Conclusions: Gestational age patterns in cesarean delivery were heterogeneous across countries; these differences highlight areas where consensus on best practices is lacking and could be used in developing strategies to reduce cesareans. (en)
Title
  • Varying gestational age patterns in cesarean delivery: an international comparison
  • Varying gestational age patterns in cesarean delivery: an international comparison (en)
skos:prefLabel
  • Varying gestational age patterns in cesarean delivery: an international comparison
  • Varying gestational age patterns in cesarean delivery: an international comparison (en)
skos:notation
  • RIV/00216208:11120/14:43909307!RIV15-MSM-11120___
http://linked.open...avai/riv/aktivita
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  • N
http://linked.open...iv/cisloPeriodika
  • Article ID 321
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http://linked.open...aciTvurceVysledku
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  • 53029
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  • RIV/00216208:11120/14:43909307
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  • Euro-Peristat; Mode of delivery; Plurality; Gestational age; Cross-national comparisons; Cesarean delivery (CD) (en)
http://linked.open.../riv/klicoveSlovo
http://linked.open...odStatuVydavatele
  • GB - Spojené království Velké Británie a Severního Irska
http://linked.open...ontrolniKodProRIV
  • [F56DE62BD27F]
http://linked.open...i/riv/nazevZdroje
  • BMC Pregnancy and Childbirth
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http://linked.open...UplatneniVysledku
http://linked.open...v/svazekPeriodika
  • 14
http://linked.open...iv/tvurceVysledku
  • Velebil, Petr
http://linked.open...ain/vavai/riv/wos
  • 000342106100002
issn
  • 1471-2393
number of pages
http://bibframe.org/vocab/doi
  • 10.1186/1471-2393-14-321
http://localhost/t...ganizacniJednotka
  • 11120
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