Cadernos de Saúde Pública
On-line version ISSN 1678-4464
FREITAS, Paulo Fontoura; SAKAE, Thiago Mamôru and JACOMINO, ; Maria Eduarda M. Lebarbechon Polli. Medical and non-medical factors associated with cesarean section rates in a university hospital in southern Brazil. Cad. Saúde Pública [online]. 2008, vol.24, n.5, pp. 1051-1061. ISSN 1678-4464. http://dx.doi.org/10.1590/S0102-311X2008000500012.
The objective of this study was to describe factors associated with the increase in cesarean rates in a university hospital in 2002 and 2004, exploring medical and non-medical factors. A cross-sectional study investigated 2,905 deliveries: 1,441 in 2002 and 1,464 in 2004. Differences in adjusted prevalence rates using Poisson regression and attributable risk percent were estimated for the associations between cesarean section and demographic, clinical, reproductive, institutional, obstetric, and delivery-related factors. The cesarean rate increased from 28.4% in 2002 to 36.7% in 2004. Higher maternal schooling, time of day at delivery, illness during pregnancy, and number of prenatal visits were associated with the excess rate in 2004 compared to 2002. The increased cesarean rate can be attributed at least partially to an increase in relative clinical indications and non-medical factors.
Keywords : Cesarean Section; Risk Factors; Attributable Risk; University Hospitals.