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Risk of caesarean section after induced labour: do hospitals make a difference?

2013Journal article Open access
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dc.contributor.authorTeixeira, Cristina
dc.contributor.authorCorreia, Sofia
dc.contributor.authorBarros, Henrique
dc.date.accessioned2013-10-10T07:51:32Z
dc.date.available2013-10-10T07:51:32Z
dc.date.issued2013
dc.description.abstractBackground: There is a well-known relationship between induced labour and caesarean rates. However, it remains unknown whether this relationship reflects the impact of more complex obstetric conditions or the variability in obstetric practices. We sought to quantify the independent role of the hospital as a variable that can influence the occurrence of caesarean section after induced labour. As part of the Portuguese Generation XXI birth cohort, we evaluated 2041 consecutive women who underwent singleton pregnancies with labour induction, at five public level III obstetric units (April 2005-August 2006). The indications for induction were classified according to the guidelines of the American and the Royal Colleges of Obstetricians and Gynaecologists. Poisson regression models were adjusted to estimate the association between the hospital and surgical delivery after induction. Crude and adjusted prevalence ratios (PR) and a 95% confidence interval (95% CI) were computed. The proportion of women who were induced without formal clinical indications varied among hospitals from 20.3% to 45.5% (p < 0.001). After adjusting for confounders, the risk of undergoing a caesarean section after induced labour remained significantly different between the hospitals, for the cases in which there was no evident indication for induction [the highest PR reaching 1.86 (95% CI, 1.23–2.82)] and also when at least one such indication was present [1.53 (95% CI, 1.12–2.10)]. This pattern was also observed among the primiparous cephalic term induced women [the highest PR reaching 2.06 (95% CI, 1.23–2.82) when there was no evident indication for induction and 1.61 (95% CI, 1.11–2.34) when at least one such indication was present]. Caesarean section after induced labour varied significantly across hospitals where similar outcomes were expected. The effect was more evident when the induction was not based on the unequivocal presence of commonly accepted indications.por
dc.identifier.citationTeixeira, Cristina; Correia, Sofia; Barros, Henrique (2013). Risk of caesarean section after induced labour: do hospitals make a difference?. BMC Research Notes. ISSN 1756-0500. 6:214, p. 1-8por
dc.identifier.issn1756-0500
dc.identifier.urihttp://hdl.handle.net/10198/8886
dc.language.isoengpor
dc.peerreviewedyespor
dc.publisherBioMed Centralpor
dc.relationSFRH/PROTEC/67591/2010
dc.subjectCaesarean sectionpor
dc.subjectHealth care servicespor
dc.subjectInduction of labourpor
dc.subjectWomen’s healthpor
dc.titleRisk of caesarean section after induced labour: do hospitals make a difference?por
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage8por
oaire.citation.startPage1por
oaire.citation.titleBMC Research Notespor
oaire.citation.volume6por
person.familyNameTeixeira
person.givenNameCristina
person.identifier.ciencia-id6E12-F2A0-568F
person.identifier.orcid0000-0001-5194-5141
person.identifier.ridO-2296-2013
person.identifier.scopus-author-id55207402700
rcaap.rightsopenAccesspor
rcaap.typearticlepor
relation.isAuthorOfPublication9037c83c-43c1-4714-ad3e-9f307dd1d89f
relation.isAuthorOfPublication.latestForDiscovery9037c83c-43c1-4714-ad3e-9f307dd1d89f

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