Cesarean Section According to Robson Classification in a Tertiary Hospital, Southern Thailand

Background and Objective: Cesarean section (CS) rates have increased continuously worldwide in the past decades while not being associated with significant benefits for mothers and newborns. According to Robson's classification, the present research aimed to analyze the associating factor to cesarean section to set the practice system and decrease the cesarean section rate in the near future. Methods:  This is a retrospective cross-sectional analytic study of the medical record of pregnant women who delivered in ۲۰۱۹ at MNST Hospital. The logistic regression model carried out the adjusted odds ratio (OR) of cesarean section rate and ۹۵% confidence intervals. Results: A total of ۵,۳۶۰ medical records were recruited. Of all birth, ۵۵.۴% occurred by cesarean section, most of whom were categorized in R۱ to R۴ of Robson classification (۲۳.۳%), followed by R۵ (۲۱.۱%) and R۱۰ (۵.۴%). The subgroup R۱-R۴ analysis demonstrated that obesity, Bachelor’s education, and private obstetrician were significantly related to the cesarean section in the group of spontaneous labor (R۱, R۳) and Bachelor’s education and private obstetrician were significantly related to the cesarean section in the group without spontaneous labor (R۲, R۴) (adjust OR ۱۳.۵۰, P<۰.۰۰۱ and adjust OR ۲.۱۱, P<۰.۰۰۱, respectively). Conclusion: Private obstetrician and education level were factors related to the obstetric indication of unnecessary cesarean section.

Keywords:

Cesarean section , Factor , Robson classification , Cesarean section rate