Lowered national cesarean section rates after a concerted action

• Type: Article in International Scientific Journal
• Date: 2015

Authors

Diogo Ayres De Campos (Author) Other; Joana Cruz (Author) Other; Claudia Medeiros Borges (Author) Other; Cristina Costa Santos (Author) FMUP; Lisa Vicente (Author) Other

Journal

Title: Acta Obstetricia et Gynecologica Scandinavica

Vol. 94

Pages: 391-398

ISSN: 0001-6349

Publisher: Wiley-Blackwell

Indexing

ISI Web of Knowledge - 26 Citations

Scopus - 27 Citations

Scientific classification

FOS: Medical and Health sciences > Clinical medicine

Other information

Authenticus ID: P-00A-8FE

DOI: 10.1111/aogs.12582

Abstract (EN): ObjectiveTo evaluate national cesarean section (CS) rates and other obstetric indicators after a concerted action to reduce CS rates was undertaken in Portugal from 2010 onwards. This action was based on the transmission of information and training of healthcare professionals, together with the inclusion of CS rates as a criterion for hospital funding. DesignRetrospective observational population-based study. SettingPortugal. PopulationBirths occurring in Portugal between 2000 and 2014. MethodsGovernmental sources were used to obtain data on national CS, perinatal and maternal mortality rates. Rates of instrumental vaginal delivery, vaginal birth after cesarean (VBAC), hypoxia-related complications and perineal lacerations were retrieved for state-owned hospitals. Main outcome measuresCS, perinatal and maternal mortality, instrumental vaginal delivery, VBAC, hypoxia-related complications and perineal lacerations. ResultsAfter a continuous rise between 2000 and 2009, national CS rates declined significantly over the following 5years (36.6% vs. 33.1%, time trend p0.001). Perinatal mortality maintained a downward trend during this period, while maternal mortality remained unchanged. Rates of instrumental vaginal delivery, VBAC and perineal lacerations increased, while the incidence of hypoxia-related complications decreased. ConclusionsA concerted action based on the transmission of information and training of healthcare professionals, together with the inclusion of CS rates as a criterion for hospital funding, was followed by a significant reduction in national CS rates, as well as an improvement in most related obstetric indicators. There may be an association between the reported intervention and the observed changes.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 8