Robson 10-groups classification system to access C-section in two public hospitals of the Federal District/Brazil

The global increase in C-section rates is real. In Brazil, these indices correspond to 58.94% in the Midwest region and 52.77% in the Federal District. To evaluate the C-section rates and identify the groups with the greatest risk at two reference hospitals in the public network of Federal District/...

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Bibliographic Details
Published in:	PloS one 2018-02, Vol.13 (2), p.e0192997-e0192997
Main Authors:	Bolognani, Cláudia Vicari, Reis, Lílian Barros de Sousa Moreira, Dias, Adriano, Calderon, Iracema de Mattos Paranhos
Format:	Article
Language:	eng
Subjects:	Cesarean section Chi-square test Childbirth & labor Classification Fetuses Gynecology Health aspects Health risk assessment Health sciences Hospitals Medical research Medical schools Medicine and Health Sciences Medicine, Experimental Obstetrics People and places Physical Sciences Pregnancy Premature birth Public health Regression analysis Research and Analysis Methods Statistical tests Statistics
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Summary:	The global increase in C-section rates is real. In Brazil, these indices correspond to 58.94% in the Midwest region and 52.77% in the Federal District. To evaluate the C-section rates and identify the groups with the greatest risk at two reference hospitals in the public network of Federal District/Brazil, using 10-Group Robson System. A cross-sectional study of 6579 births assisted at the Hospital A (HA) and the Hospital B (HB) during 2013. The C-section rates in each group and its respective contribution to the total hospital C-sections was compared between HA and HB. To this, was used the proportion difference test (similar to chi-square test), with RR and 95% CI, and the logistic regression analysis (OR; 95% CI) among the groups with higher C-section/total C-section. The significance limit of p < 0.05 was defined for all tests. The C-section rates were 50.8% at the HA and 42.3% at the HB, with 1.20 RR (95%CI = 1.13-1.28) at the HA. The highest rates were observed in Robson groups G5, G1, and G2. At the HA, G1 had a 21.5% C-section rate, which was greater than at the HB (13.8%; p < 0.05); the cesarean rates for groups G2 and G5 were higher at the HB (respectively, 18.6 and 38.1%) than at the HA (14.8 and 32.5%, respectively; p < 0.05). These results point out specific goals to be achieved in order to reduce abusive cesarean rates in both A and B hospitals, especially in the primigravida and in those with previous C-section.
ISSN:	1932-6203 1932-6203