Journal of Epidemiology and Global Health

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Volume 9, Issue 4, December 2019, Pages 252 - 258

Maternal Factors Associated with Mode of Delivery in a Population with a High Cesarean Section Rate

Authors
Tamala Gondwe1, Kalpana Betha2, G.N. Kusneniwar3, Clareann H. Bunker1, Gong Tang4, Hyagriv Simhan5, 6, P.S. Reddy2, 3, Catherine L. Haggerty1, 6, *
1Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
2Department of Obstetrics and Gynecology, SHARE INDIA, MediCiti Institute of Medical Sciences, Ghanpur, Telangana 501401, India
3Department of Community Medicine, SHARE INDIA, MediCiti Institute of Medical Sciences, Ghanpur, Telangana 501401, India
4Department of Biostatistics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
5Department of Obstetrics, Gynecology, and Reproductive Sciences, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
6Magee-Womens Research Institute, Pittsburgh, PA, USA
*Corresponding author. Email: haggerty@pitt.edu
Corresponding Author
Catherine L. Haggerty
Received 25 February 2019, Accepted 5 October 2019, Available Online 30 October 2019.
DOI
10.2991/jegh.k.191017.001How to use a DOI?
Keywords
Global health; India; cesarean section
Abstract

We sought to identify factors associated with mode of delivery in a peri-urban Indian population with a high cesarean section rate. Poisson regression with robust error variance was applied to model factors associated with cesarean compared to vaginal delivery in a prospective, preconception pregnancy cohort study in Telangana State, India. Adjusted relative risks and 95% confidence intervals from multivariable models are presented. Among 1164 singleton births between 2010 and 2015, 46% were delivered by cesarean. In multiparous women (n = 674), prior cesarean delivery (4.2, 3.2–5.6), prior twin delivery (1.4, 1.1–1.9), diagnosis of hypertension (1.4, 1.0–2.0), or preeclampsia (3.5, 2.1–5.7) in a prior pregnancy independently increased the risk of cesarean. Prepregnancy overweight/obesity (1.4, 1.0–1.9), a composite of prenatal complications (1.3, 1.0–1.7), a composite of labor complications (1.5, 1.0–2.3), nonreassuring fetal heart rate (2.3, 1.3–4.1), and breech position (2.6, 1.4–5.0) also increased the cesarean risk. Among nulliparous women (n = 233), cephalo–pelvic disproportion (1.9, 1.2–3.0), a composite of labor complications (2.9, 1.8–4.9), and breech position (3.4, 1.9–6.2) increased the risk of cesarean. The high rate of cesarean delivery in this peri-urban Indian population is attributed to history of pregnancy complications, history of prior cesarean, prepregnancy body mass index, and medical indications at delivery.

Copyright
© 2019 Atlantis Press International B.V.
Open Access
This is an open access article distributed under the CC BY-NC 4.0 license (http://creativecommons.org/licenses/by-nc/4.0/).

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<Previous Article In Issue
Next Article In Issue>
Journal
Journal of Epidemiology and Global Health
Volume-Issue
9 - 4
Pages
252 - 258
Publication Date
2019/10/30
ISSN (Online)
2210-6014
ISSN (Print)
2210-6006
DOI
10.2991/jegh.k.191017.001How to use a DOI?
Copyright
© 2019 Atlantis Press International B.V.
Open Access
This is an open access article distributed under the CC BY-NC 4.0 license (http://creativecommons.org/licenses/by-nc/4.0/).

Cite this article

risenwbib
TY  - JOUR
AU  - Tamala Gondwe
AU  - Kalpana Betha
AU  - G.N. Kusneniwar
AU  - Clareann H. Bunker
AU  - Gong Tang
AU  - Hyagriv Simhan
AU  - P.S. Reddy
AU  - Catherine L. Haggerty
PY  - 2019
DA  - 2019/10/30
TI  - Maternal Factors Associated with Mode of Delivery in a Population with a High Cesarean Section Rate
JO  - Journal of Epidemiology and Global Health
SP  - 252
EP  - 258
VL  - 9
IS  - 4
SN  - 2210-6014
UR  - https://doi.org/10.2991/jegh.k.191017.001
DO  - 10.2991/jegh.k.191017.001
ID  - Gondwe2019
ER  -