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A prospective study of maternal, fetal and neonatal outcomes in the setting of cesarean section in low‐ and middle‐income countries

Acta obstetricia et gynecologica Scandinavica, 2017-04, Vol.96 (4), p.410-420 [Peer Reviewed Journal]

2017. This article is a U.S. Government work and is in the public domain in the USA. ;Copyright © 2017 Acta Obstetricia et Gynecologica Scandinavica ;ISSN: 0001-6349 ;EISSN: 1600-0412 ;DOI: 10.1111/aogs.13098 ;PMID: 28107771 ;CODEN: AOGSAE

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Title:
A prospective study of maternal, fetal and neonatal outcomes in the setting of cesarean section in low‐ and middle‐income countries
Author: Harrison, Margo S. ; Pasha, Omrana ; Saleem, Sarah ; Ali, Sumera ; Chomba, Elwyn ; Carlo, Waldemar A. ; Garces, Ana L. ; Krebs, Nancy F. ; Hambidge, K. Michael ; Goudar, Shivaprasad S. ; Kodkany, Bhala ; Dhaded, Sangappa ; Derman, Richard J. ; Patel, Archana ; Hibberd, Patricia L. ; Esamai, Fabian ; Liechty, Edward A. ; Moore, Janet L. ; Wallace, Dennis ; Mcclure, Elizabeth M. ; Miodovnik, Menachem ; Koso‐Thomas, Marion ; Belizan, Jose ; Tshefu, Antoinette K. ; Bauserman, Melissa ; Goldenberg, Robert L.
Subjects: Adult ; Cesarean section ; Cesarean Section - statistics & numerical data ; Developing Countries ; Female ; Humans ; Infant ; Infant Mortality ; Infant, Newborn ; low‐ and middle‐income countries ; Male ; Maternal Health Services ; maternal morbidity ; Maternal Mortality ; neonatal morbidity ; neonatal mortality ; Obstetric Labor Complications - mortality ; Pregnancy ; Pregnancy Outcome ; Prospective Studies ; Socioeconomic Factors ; Stillbirth - epidemiology ; Young Adult
Is Part Of: Acta obstetricia et gynecologica Scandinavica, 2017-04, Vol.96 (4), p.410-420
Description: Introduction Cesarean section (CS) rates are increasing globally with an unclear effect on pregnancy outcomes. The study objective was to quantify maternal and perinatal morbidity and mortality associated with CS compared with vaginal delivery (VD) both within and across sites in low‐ and middle‐income countries. Material and methods A prospective population‐based study including home and facility births in 337 153 women with a VD and 47 308 women with a CS from 2010 to 2015 was performed in Guatemala, India, Kenya, Pakistan, Zambia and Democratic Republic of Congo. Women were enrolled during pregnancy; delivery and 6‐week follow‐up data were collected. Results Across all sites, CS rates increased from 8.6% to 15.2%, but remained low in African sites. Younger, nulliparous women were more likely to have a CS, as were women with higher education and those delivering an infant weighing 1500–2499 g. Across all sites, maternal and neonatal mortality was higher, and stillbirths were lower, in pregnancies delivered by CS. Antepartum and postpartum complications as well as obstetric interventions and treatments were more common among women who underwent CS. In stratified analyses, all outcomes were worse in women with a CS compared with VD in African compared to non‐African sites. Conclusions CS rates increased across all sites during the study period, but at more pronounced rates in the non‐African sites. CS was associated with reduced postpartum hemorrhage and lower rates of stillbirths in the non‐African sites. In the African sites, CS was associated with an increase in all adverse outcomes. Further studies are necessary to better understand the increase in adverse outcomes with CS in the African sites.
Publisher: United States: Wiley Subscription Services, Inc
Language: English;French;German
Identifier: ISSN: 0001-6349
EISSN: 1600-0412
DOI: 10.1111/aogs.13098
PMID: 28107771
CODEN: AOGSAE
Source: Journals@Ovid Open Access Journal Collection Rolling
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A prospective study of maternal, fetal and neonatal outcomes in the setting of cesarean section in low‐ and middle‐income countries

2017. This article is a U.S. Government work and is in the public domain in the USA. ;Copyright © 2017 Acta Obstetricia et Gynecologica Scandinavica ;ISSN: 0001-6349 ;EISSN: 1600-0412 ;DOI: 10.1111/aogs.13098 ;PMID: 28107771 ;CODEN: AOGSAE

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