We found a match
Your institution may have rights to this item. Sign in to continue.
- Title
Higher Cesarean Delivery Rates are Associated with Higher Infant Mortality Rates in Industrialized Countries.
- Authors
Xie, Ri-hua; Gaudet, Laura; Krewski, Daniel; Graham, Ian D.; Walker, Mark C.; Wen, Shi Wu
- Abstract
Background Recent data indicate that more than half of high-income industrialized countries have a cesarean delivery rate of > 25 percent, which is higher than the appropriate level considered by most health professionals worldwide. Methods Data for 31 high-income industrialized countries in 2010 (or the nearest year) obtained from the World Health Organization, Organization for Economic Cooperation and Development, World Bank, and individual countries were analyzed in this study. We examined the correlation between cesarean delivery rate and infant mortality rate with Pearson correlation coefficient analysis, and examined the independent effect of cesarean delivery on infant mortality with multiple linear regression analyses. Results The cesarean delivery and infant mortality rates varied substantially among the included countries: from 15.6 to 50.0 percent and from 1.9 per to 6.8 per 1,000 live births, respectively. Cesarean delivery rates were positively correlated with infant mortality rates (Pearson correlation coefficient: 0.41, p < 0.05). The association remained after adjustment for maternal age, infant sex, per capita GDP, and the Gini index ( p < 0.03), but disappeared after further adjustment for preterm birth ( p = 0.07). In a sensitivity analysis, the results were not appreciably affected by excluding births at < 22 weeks of gestation, by weighting the data by the number of births in each country, or by excluding data from particular countries with possible measurement issues ( USA, Greece). Conclusions A higher cesarean delivery rate is associated with higher infant mortality rate among these high-income industrialized countries. One of the mechanisms by which cesarean delivery affects infant mortality is through iatrogenic prematurity.
- Subjects
CESAREAN section; STATISTICAL correlation; INCOME; PREMATURE infants; INFANT mortality; MATERNAL age; RESEARCH methodology; POPULATION geography; REPORT writing; MULTIPLE regression analysis; SECONDARY analysis; PARITY (Obstetrics); DESCRIPTIVE statistics; DEVELOPED countries
- Publication
Birth: Issues in Perinatal Care, 2015, Vol 42, Issue 1, p62
- ISSN
0730-7659
- Publication type
Article
- DOI
10.1111/birt.12153