FRIDAY, Oct. 12, 2018 — Global cesarean section (CS) rates are increasing, according to one in a series of three papers published online Oct. 11 in The Lancet.

Ties Boerma, Ph.D., from the University of Manitoba in Winnipeg, Canada, and colleagues evaluated trends in CS use using data from 169 countries, including 98.4 percent of the world’s births. The researchers estimated that in 2015, 29.7 million births occurred through CS, which was almost double the 16.0 million CS births in 2000. In the Latin American and Caribbean region, CS use in 2015 was up to 10 times more frequent than in the west and central Africa region (44.3 versus 4.1 percent of births). An increasing proportion of births occurring in health facilities and increases in CS use within health facilities were drivers of the global and regional increases in CS use (66.5 and 33.5 percent of the global increase, respectively). CS use also varied based on country disparity with nearly five times more frequency in births in the richest versus the poorest quintiles in low-income and middle-income countries.

In a second paper, Jane Sandall, Ph.D., from King’s College London, and colleagues discuss the effects of CS on the health of women and children. The authors note that the prevalence of maternal mortality and morbidity are increased after CS versus vaginal birth. Altered immune development and increased likelihood of allergy, atopy, and asthma are included as short-term CS risks. In the third paper, Ana Pilar Betrán, Ph.D., from the World Health Organization in Geneva, and colleagues discuss interventions to reduce unnecessary CS, which should include educational interventions complemented with meaningful dialogue and emotional support.

“Interventions to reduce overuse must be multicomponent and locally tailored, addressing women’s and health professionals’ concerns, as well as health system and financial factors,” Betrán and colleagues write.

Two authors from the Sandall paper disclosed involvement in a study funded by Evolve Biosystems.

Abstract/Full Text – Boerma (subscription or payment may be required)
Abstract/Full Text – Sandall (subscription or payment may be required)
Abstract/Full Text – Betrán (subscription or payment may be required)
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Posted: October 2018

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