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Global incidence of caesarean deliveries on maternal request: a systematic review and meta-regression

Begum, T., Saif-Ur-Rahman, K. M., Yaqoot, F., Stekelenburg, J., Anuradha, S., Biswas, T., Doi, S. A. & Mamun, A. A., 8-Oct-2020, In : BJOG : An International Journal of Obstetrics and Gynaecology. 9 p.

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  • Global incidence of caesarean deliveries on maternal request

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DOI

  • Tahmina Begum
  • K M Saif-Ur-Rahman
  • Fatima Yaqoot
  • Jelle Stekelenburg
  • Satyamurthy Anuradha
  • Tuhin Biswas
  • Suhail A Doi
  • Abdullah Al Mamun

BACKGROUND: Caesarean delivery on maternal request (CDMR) is considered as a significant contributor to the unprecedented increase in the caesarean deliveries (CD) for non-clinical reasons. Current literature lacks a reliable assessment of the rate of CDMR, which hinders the planning and delivery of appropriate interventions for reducing the CDMR rates.

OBJECTIVES: Conduct a systematic review of literature and meta-regression to explore the global incidence of CDMR.

SEARCH STRATEGY: Pubmed, Embase, CINAHL, Medline, Google scholar and grey literature were searched from January 1985 to May 2019.

SELECTION CRITERIA: Observational studies that report CDMR data were included. We excluded non- English articles, case notes, editorial reviews and articles reporting elective CDs from pregnancy risk factors.

DATA COLLECTION AND ANALYSIS: Two reviewers independently conducted the screening and quality appraisal using a validated tool. The weighted average of CDMR over total deliveries (absolute proportion)and by total CDs (relative proportion) were generated. Quality effect meta-regression was used to explain the variability of the CDMR estimates by moderators, including study methodology and demography of study participants.

RESULTS: We identified 31 articles from 14 countries that include 5 million total births. The absolute proportion of CDMR varies between 0.2% to 42% with significant variations across studies and sub-groups. The economic status of the country and study year both together explained 84% of absolute and 76% of the relative proportion of CDMR variations.

CONCLUSIONS: An appropriate reporting of CDMR should be a key priority in maternal health policies and practices.

Original languageEnglish
Number of pages9
JournalBJOG : An International Journal of Obstetrics and Gynaecology
Early online date14-Sep-2020
Publication statusPublished - 8-Oct-2020

    Keywords

  • Caesarean section, global incidence, maternal request, GESTATIONAL-AGE, SECTION, RISK, METAANALYSIS, BIRTH, CHILDBIRTH, OBESITY, WOMEN, BIAS, DETERMINANTS

ID: 134374390