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. 2020 Nov 23;20(1):715.
doi: 10.1186/s12884-020-03398-6.

Trends in cesarean delivery rates in primipara and the associated factors

Guoqiang Sun  1 , Ying Lin  1 , Honglian Lu  1 , Wenjing He  1 , Ruyan Li  1 , Lijun Yang  1 , Xian Liu  1 , Hongyan Wang  1 , Xuewen Yang  1 , Yao Cheng  2
Affiliations

Trends in cesarean delivery rates in primipara and the associated factors

Guoqiang Sun et al. BMC Pregnancy Childbirth. .

Abstract

Background: Few studies have focused on cesarean delivery (CD) trends among primipara under the one-child and the two-child policies. This study aimed to explore the trends in CD rates among primipara during 1995-2019 and the associated factors with CD risk.

Methods: This study obtained clinical data on primiparous mothers and newborns from 1995 to 2019 at a large tertiary hospital in Wuhan, China. Trends in CD rates were calculated using the joinpoint regression analysis. The Chi-square tests and log-binomial regression analyses were used to evaluate the associations between primary variables and CD risk.

Results: CD rates showed a significant upward trend with an average annual percentage change (APC) of 2.2% (95% CI: 0.6, 3.8%) during the study period. In 1995-2006, the CD rates continued to increase with an APC of 7.8% (95% CI: 4.8, 10.9%). After 2006, the CD rates started to decline by an APC of - 4.1% (95% CI: - 5.5, - 2.6%). The CD rates non-significantly increased from 36.2% in 2016 to 43.2% in 2019. Moreover, the highest CD rate during 2015-2019 was observed on August 30 (59.2%) and the lowest on September 1 (29.7%). Primipara of older age and those with >3pregnancies had higher risks of CD. Furthermore, primipara who gave birth to newborns with low birth weight and macrosomia had higher risks of CD.

Conclusions: Maternal and fetal as well as social and cultural factors may contribute to the rising trend of CD rates. Effective measures should be taken to control CD under the two-child policy, especially for primipara.

Keywords: Annual percentage change; Average annual percentage changes; Cesarean delivery; Child policy; Primipara.

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Conflict of interest statement

The authors declare no potential conflict of interests.

Figures

Fig. 1
Fig. 1
Trends in cesarean delivery rates among primipara during 1995–2019
Fig. 2
Fig. 2
Daily average cesarean delivery rates among primipara during 1995–2019
Fig. 3
Fig. 3
Trends in cesarean delivery rates among primipara stratified by age during 1995–2019
Fig. 4
Fig. 4
Trends in cesarean delivery rates among primipara with singleton pregnancies stratified by birth weight during 1995–2019
See this image and copyright information in PMC

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