Prevalence and Predictors of Cesarean Section in Zanjan-Iran during 2014-2016

Abstract

Background: The increased prevalence of cesarean section (C–section) is a global epidemic. Objectives: The aim of this study was to determine the prevalence and demographic, fertility, and childbirth-related factors of C–section in Zanjan province, Iran,-from 21 March 2014 to 19 March 2016. Methods: This study was a descriptive analytic study, carried out in 2014–2016, which gathered 41, 265 registered childbirth data in Zanjan province hospitals and from country electronic childbirth register system. Data were analyzed using descriptive, univariate and multivariate logistic binominal regression. Results: according to the findings, the prevalence of C–section was 40.1%. The odds of having C–section went up with increasing maternal age (OR=1.026), gravidity (OR=0.670), and gestational age (OR=0.093), while it decreased with an increased parity, end educational level up to high school graduate. In contrast, higher educational (OR=3.064) level increased the odds of having C–section. Living in the urban areas (OR=1.855) also increased the oddsof C–section. Diabetes (OR=1.990), preeclampsia or eclampsia (OR=2.350), hypertension (OR=1.983), and thyroid disorders (OR=2.289) increased the odds of having C–section. Newborns with low birth weight (OR=1) and macrosomia (OR=2.663), and boys (OR=1.107) were delivered more via C–section. Among the interventions during labor, induction (OR=1.131) and stimulation of labor (OR=0.269) reduced the odds of C–section (P<0.05). Conclusion: C–section rate is very high in Iran and its association with different variables can be a basis for planning and policymaking in order to reduce the C–section rate, particularly in Zanjan province.

Keywords

• cesarean section
• prevalence
• risk factors
• Zanjan