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Influence of hospital characteristics on the performance of elective cesareans in Southeast Brazil.

Authors :
Zaiden L
Nakamura-Pereira M
Gomes MAM
Esteves-Pereira AP
Leal MDC
Source :
Cadernos de saude publica [Cad Saude Publica] 2019 Dec 20; Vol. 36 (1), pp. e00218218. Date of Electronic Publication: 2019 Dec 20 (Print Publication: 2019).
Publication Year :
2019

Abstract

This article aims to assess the influence of hospital characteristics on the odds of performing an elective cesarean in the Southeast region of Brazil. Data were obtained from the Birth in Brazil study, conducted from February 2011 to October 2012. The current analysis includes the sample from Southeast Brazil, with 10,155 women. The group of women that underwent elective cesareans was compared to the women who went into labor or underwent labor induction, regardless they had intrapartum cesarean or vaginal delivery. Except for gestational age, all the obstetric characteristics analyzed were associated with elective cesarean. In this group, 60.5% had no prior cesarean and 64.7% had low-risk gestations. Among the births with public financing, there were higher odds of elective cesareans in women treated at hospitals with < 1,500 births/year (OR = 2.11; 95%CI: 1.37-3.26) and 1,500-2,999 births/year (OR = 1.45; 95%CI: 1.04-2.02) and in mixed hospitals (OR = 1.81; 95%CI: 1.37-2.39). In the mixed hospitals, the association was stronger when located in non-capital cities with > 3,000 births/year (OR = 3.45; 95%CI: 1.68-7.08), reaching the highest level in hospitals in non-capital cities with < 3,000 births/year (OR = 4.08; 95%CI: 2.61-6.37). Meanwhile, no association was seen between elective cesarean and public hospitals located in non-capital cities of the Southeast region. Prevalence rates of elective cesareans in public hospitals in Southeast Brazil are high when compared to other countries, and they are heavily influenced by hospital characteristics.

Details

Language :
English; Portuguese
ISSN :
1678-4464
Volume :
36
Issue :
1
Database :
MEDLINE
Journal :
Cadernos de saude publica
Publication Type :
Academic Journal
Accession number :
31939550
Full Text :
https://doi.org/10.1590/0102-311X00218218