Caesarean birth rates in public and privately funded hospitals

A cross-sectional study

Datos Bibliográficos

ID16780355
AutoresBruna Dias Alonso (0000-0001-8259-4807, Universidade de São Paulo), Flora Maria Barbosa da Silva (0000-0002-0094-3055, Universidade de São Paulo), Maria Do Rosário Dias De Oliveira Latorre (0000-0002-5189-3457, Universidade de São Paulo), Carmen Simone Grilo Diniz (0000-0002-0069-2532, Universidade de São Paulo), Debra Bick (0000-0002-8557-7276, King's College London)
Año2017
Volumen51
Páginas101
Fecha de publicación2017-11-27
Peer ReviewedSí
Open AccessSí
TipoARTICLE
RevistaRevista de Saúde Pública (JOURNAL)
Identificadores de la revistaISSN: 0034-8910 • E-ISSN: 0034-8910
EditorialUniversidade de Sao Paulo, Agencia USP de Gestao da Informacao Academica (AGUIA) (PUBLISHER)
DOI10.11606/s1518-8787.2017051007054
PMID29166449
OpenAlexW2769932490
IdiomaEN
Citas recibidas6
Referencias citadas9

OBJECTIVE: To examine maternal and obstetric factors influencing births by cesarean section according to health care funding. METHODS: A cross-sectional study with data from Southeastern Brazil. Caesarean section births from February 2011 to July 2012 were included. Data were obtained from interviews with women whose care was publicly or privately funded, and from their obstetric and neonatal records. Univariate and multivariate analyses were conducted to generate crude and adjusted odds ratios (OR) with 95% confidence intervals (95%CI) for caesarean section births. RESULTS: The overall caesarean section rate was 53% among 9,828 women for whom data were available, with the highest rates among women whose maternity care was privately funded. Reasons for performing a c-section were infrequently documented in women’s maternity records. The variables that increased the likelihood of c-section regardless of health care funding were the following: paid employment, previous c-section, primiparity, antenatal and labor complications. Older maternal age, university education, and higher socioeconomic status were only associated with c-section in the public system. CONCLUSIONS: Higher maternal socioeconomic status was associated with greater likelihood of a caesarean section birth in publicly funded settings, but not in the private sector, where funding source alone determined the mode of birth rather than maternal or obstetric characteristics. Maternal socioeconomic status and private healthcare funding continue to drive high rates of caesarean section births in Brazil, with women who have a higher socioeconomic status more likely to have a caesarean section birth in all birth settings

Caesarean section · Confidence interval · Cross-sectional study · Environmental health · Family medicine · Logistic regression · Obstetrics · Odds · Odds ratio · Population · Pregnancy · Socioeconomic status · Demography · Global Maternal and Child Health · Maternal and Neonatal Healthcare · Maternal and Perinatal Health Interventions · Medicine