Abstract
Background: Although caesarean sections are more common for heavier babies and for those who are preterm or post-term, caesarean rates have increased in all birthweight categories in several countries.
Objective: To analyse the distribution of birthweight and gestational age according to type of delivery in two maternity hospitals with discrepant caesarean section rates in Brazil.
Methods: The study was a retrospective analysis of all singleton live births at two hospitals in RibeirĪ³o Preto, Brazil, in 1999, corresponding to 70% of all deliveries in the city, one being public and the other private. Mean birthweight and mean gestational age and the distribution of birthweight and gestational age according to the type of delivery (vaginal or caesarean) were analysed in each hospital.
Results: The caesarean rate was 18.9% in the public maternity hospital and 84.3% in the private one. Mean birthweight in the public hospital was 3200g and 3279g for vaginal and caesarean delivery, respectively (p=0.074), and 3155g and 3158g (P>0.10) in the private hospital. The birthweight distribution in both hospitals followed a Gaussian distribution. In the public hospital, caesarean section was more common for babies with birthweight between 1500g and 2499g and over 3500g (p<0.001), whilst in the private one the higher rates were found for birthweights between 3000 and 3449g (p=0.073). The public maternity showed a gestational age distribution with a shift to the right, towards older gestational ages, with caesarean sections being performed mostly among post-term babies. The private hospital showed a peak around the gestational age of 38.5 weeks.
Conclusions: In the private setting, higher caesarean rates among babies with birthweight in the normal range and among those with gestational ages around the mean (38.5 weeks), who are at lower gestational risk, suggest that surgical deliveries were mostly performed without a medical indication at the private maternity.
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Bettiol, H., Almeida, S., Barbieri, M. et al. 38 Birthweight, Gestational Age and Type of Delivery: Comparison Between Two Hospitals with Discrepant Rates of Caesarean Section.. Pediatr Res 58, 361 (2005). https://doi.org/10.1203/00006450-200508000-00067
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DOI: https://doi.org/10.1203/00006450-200508000-00067