Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2018 Apr;16(4):221-234.

Prevalence, causes, and complications of cesarean delivery in Iran: A systematic review and meta-analysis

Mohammad Rafiei  1 , Marzieh Saei Ghare  2 , Malihe Akbari  3 , Faezeh Kiani  4 , Fatemeh Sayehmiri  5 , Koroush Sayehmiri  6 , Reza Vafaee  5
Affiliations
Review

Prevalence, causes, and complications of cesarean delivery in Iran: A systematic review and meta-analysis

Mohammad Rafiei et al. Int J Reprod Biomed. 2018 Apr.

Abstract

Background: Uncontrolled increase of C-section is one of the major problems in Iranian health system, such that C-section is the most common surgical procedure in the entire country's hospitals in Obstetrics and Gynecology sections. A variety of complications also come along with cesarean.

Objective: The aim of this study was to evaluate the prevalence, causes, and complications of cesarean in Iran.

Materials and methods: forty-one articles were considered with respect to certain criteria and were included in a systematic review to perform a meta-analysis study. The systematic review's search was conducted on SID, Iranmedx, Magiran, Medlib, PubMed, and Science Direct databases published between1999-2016. The weight of each included study was calculated according to its sample size and the reported prevalence of binomial distribution. A random-effects model using R and STATA (Version 11.2) software was utilized for analyzing data.

Results: The total number of the sample was 197514 pregnant women with a mean age of 26.72 yr. The prevalence of cesarean in Iran was estimated at 48%. The main reasons for the prevalence of cesarean in this study were mothers' higher education, previous cesarean, and doctor recommendation. The most frequent complication in women undergoing cesarean was the muscular pain, and the most common fetal complications in newborns by caesarean delivery was transient tachypnea.

Conclusion: The prevalence of C-section in Iran is much higher than what WHO recommends. It is essential, to decrease such a phenomenon, making the mothers aware of the risks of cesarean delivery, and establishing counselling sessions as well to eliminate the mothers' fear of vaginal delivery.

Keywords: Cesarean; Iran; Meta-analysis; Prevalence.

PubMed Disclaimer

Conflict of interest statement

There are no benefits in any form have been or will be received from a commercial party related directly or indirectly to the subject of this article.

Figures

Figure 1
Figure 1
Flow diagram of prevalence, causes, and complications of cesarean delivery in Iran
Figure 2
Figure 2
The prevalence of cesarean delivery in Iran based on random effects model. The midpoint of each segment is the estimate of prevalence and segment lengths show the 95% CI for each study. The diamond mark shows the prevalence in the country for all studies
Figure 3
Figure 3
The frequency of socio-demographic factors affecting the incidence of caesarean (Y axis: percent
Figure 4
Figure 4
The frequency of obstetric-medical factors affecting the incidence of cesarean delivery
Figure 5
Figure 5
The frequency of non-obstetric-medical factors affecting the incidence of cesarean delivery
Figure 6
Figure 6
Comparison of maternal complications in cesarean and vaginal delivery
Figure 7
Figure 7
Comparison of neonatal complications in infants born by cesarean and vaginal delivery
Figure 8
Figure 8
A) Funnel plot for checking publication bias. B) Trim and filled analysis for publication bias
See this image and copyright information in PMC

References

    1. Kayongo M, Rubardt M, Butera J, Abdullah M, Mboninyibuka D, Madili M. Making EmOC a reality-CARE's experiences in areas of high maternal mortality in Africa. Int J Gynecol Obstet. 2006;92:308–319. - PubMed
    1. Alehagen S, Wijma K, Wijma B. Fear during labor. Acta Obstet Gynecol Scand. 2001;80:315–320. - PubMed
    1. Bagheri A, Masoodi-Alavi N, Abbaszade F. [Effective factors for choosing the delivery method among the pregnant women in Kashan] Feyz J. 2012;16:146–153.
    1. Shakeri M, Mazloumzade S, Mohamaian F. [Factors affecting the rate of cesarean section in Zanjan maternity hospitals in 2008] Zanjan Univ Med Sci J. 2012;20:98–104.
    1. Lee AS, Kirkman M. Disciplinary discourses: rates of cesarean section explained by medicine, midwifery, and feminism. Health Care Women Int. 2008;29:448–467. - PubMed

LinkOut - more resources