Cesarean section trends in the Nordic Countries – a comparative analysis with the Robson classification
Abstract Introduction The cesarean rates are low but increasing in most Nordic countries. Using the Robson classification, we analyzed which obstetric groups have contributed to the changes in the cesarean rates. Material and methods Retrospective population‐based registry study including all delive...
Published in: | Acta Obstetricia et Gynecologica Scandinavica |
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crwiley:10.1111/aogs.13108 2024-10-06T13:49:57+00:00 Cesarean section trends in the Nordic Countries – a comparative analysis with the Robson classification Pyykönen, Aura Gissler, Mika Løkkegaard, Ellen Bergholt, Thomas Rasmussen, Steen C. Smárason, Alexander Bjarnadóttir, Ragnheiður I. Másdóttir, Birna B. Källén, Karin Klungsoyr, Kari Albrechtsen, Susanne Skjeldestad, Finn E. Tapper, Anna‐Maija 2017 http://dx.doi.org/10.1111/aogs.13108 https://api.wiley.com/onlinelibrary/tdm/v1/articles/10.1111%2Faogs.13108 https://obgyn.onlinelibrary.wiley.com/doi/pdf/10.1111/aogs.13108 en eng Wiley http://onlinelibrary.wiley.com/termsAndConditions#vor Acta Obstetricia et Gynecologica Scandinavica volume 96, issue 5, page 607-616 ISSN 0001-6349 1600-0412 journal-article 2017 crwiley https://doi.org/10.1111/aogs.13108 2024-09-11T04:17:44Z Abstract Introduction The cesarean rates are low but increasing in most Nordic countries. Using the Robson classification, we analyzed which obstetric groups have contributed to the changes in the cesarean rates. Material and methods Retrospective population‐based registry study including all deliveries (3 398 586) between 2000 and 2011 in Denmark, Finland, Iceland, Norway and Sweden. The Robson group distribution, cesarean rate and contribution of each Robson group were analyzed nationally for four 3‐year time periods. For each country, we analyzed which groups contributed to the change in the total cesarean rate. Results Between the first and the last time period studied, the total cesarean rates increased in Denmark (16.4 to 20.7%), Norway (14.4 to 16.5%) and Sweden (15.5 to 17.1%), but towards the end of our study, the cesarean rates stabilized or even decreased. The increase was explained mainly by increases in the absolute contribution from R5 (women with previous cesarean) and R2a (induced labor on nulliparous). In Finland, the cesarean rate decreased slightly (16.5 to 16.2%) mainly due to decrease among R5 and R6–R7 (breech presentation, nulliparous/multiparous). In Iceland, the cesarean rate decreased in all parturient groups (17.6 to 15.3%), most essentially among nulliparous women despite the increased induction rates. Conclusions The increased total cesarean rates in the Nordic countries are explained by increased cesarean rates among nulliparous women, and by an increased percentage of women with previous cesarean. Meanwhile, induction rates on nulliparous increased significantly, but the impact on the total cesarean rate was unclear. The Robson classification facilitates benchmarking and targeting efforts for lowering the cesarean rates. Article in Journal/Newspaper Iceland Wiley Online Library Norway Acta Obstetricia et Gynecologica Scandinavica 96 5 607 616 |
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Wiley Online Library |
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crwiley |
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English |
description |
Abstract Introduction The cesarean rates are low but increasing in most Nordic countries. Using the Robson classification, we analyzed which obstetric groups have contributed to the changes in the cesarean rates. Material and methods Retrospective population‐based registry study including all deliveries (3 398 586) between 2000 and 2011 in Denmark, Finland, Iceland, Norway and Sweden. The Robson group distribution, cesarean rate and contribution of each Robson group were analyzed nationally for four 3‐year time periods. For each country, we analyzed which groups contributed to the change in the total cesarean rate. Results Between the first and the last time period studied, the total cesarean rates increased in Denmark (16.4 to 20.7%), Norway (14.4 to 16.5%) and Sweden (15.5 to 17.1%), but towards the end of our study, the cesarean rates stabilized or even decreased. The increase was explained mainly by increases in the absolute contribution from R5 (women with previous cesarean) and R2a (induced labor on nulliparous). In Finland, the cesarean rate decreased slightly (16.5 to 16.2%) mainly due to decrease among R5 and R6–R7 (breech presentation, nulliparous/multiparous). In Iceland, the cesarean rate decreased in all parturient groups (17.6 to 15.3%), most essentially among nulliparous women despite the increased induction rates. Conclusions The increased total cesarean rates in the Nordic countries are explained by increased cesarean rates among nulliparous women, and by an increased percentage of women with previous cesarean. Meanwhile, induction rates on nulliparous increased significantly, but the impact on the total cesarean rate was unclear. The Robson classification facilitates benchmarking and targeting efforts for lowering the cesarean rates. |
format |
Article in Journal/Newspaper |
author |
Pyykönen, Aura Gissler, Mika Løkkegaard, Ellen Bergholt, Thomas Rasmussen, Steen C. Smárason, Alexander Bjarnadóttir, Ragnheiður I. Másdóttir, Birna B. Källén, Karin Klungsoyr, Kari Albrechtsen, Susanne Skjeldestad, Finn E. Tapper, Anna‐Maija |
spellingShingle |
Pyykönen, Aura Gissler, Mika Løkkegaard, Ellen Bergholt, Thomas Rasmussen, Steen C. Smárason, Alexander Bjarnadóttir, Ragnheiður I. Másdóttir, Birna B. Källén, Karin Klungsoyr, Kari Albrechtsen, Susanne Skjeldestad, Finn E. Tapper, Anna‐Maija Cesarean section trends in the Nordic Countries – a comparative analysis with the Robson classification |
author_facet |
Pyykönen, Aura Gissler, Mika Løkkegaard, Ellen Bergholt, Thomas Rasmussen, Steen C. Smárason, Alexander Bjarnadóttir, Ragnheiður I. Másdóttir, Birna B. Källén, Karin Klungsoyr, Kari Albrechtsen, Susanne Skjeldestad, Finn E. Tapper, Anna‐Maija |
author_sort |
Pyykönen, Aura |
title |
Cesarean section trends in the Nordic Countries – a comparative analysis with the Robson classification |
title_short |
Cesarean section trends in the Nordic Countries – a comparative analysis with the Robson classification |
title_full |
Cesarean section trends in the Nordic Countries – a comparative analysis with the Robson classification |
title_fullStr |
Cesarean section trends in the Nordic Countries – a comparative analysis with the Robson classification |
title_full_unstemmed |
Cesarean section trends in the Nordic Countries – a comparative analysis with the Robson classification |
title_sort |
cesarean section trends in the nordic countries – a comparative analysis with the robson classification |
publisher |
Wiley |
publishDate |
2017 |
url |
http://dx.doi.org/10.1111/aogs.13108 https://api.wiley.com/onlinelibrary/tdm/v1/articles/10.1111%2Faogs.13108 https://obgyn.onlinelibrary.wiley.com/doi/pdf/10.1111/aogs.13108 |
geographic |
Norway |
geographic_facet |
Norway |
genre |
Iceland |
genre_facet |
Iceland |
op_source |
Acta Obstetricia et Gynecologica Scandinavica volume 96, issue 5, page 607-616 ISSN 0001-6349 1600-0412 |
op_rights |
http://onlinelibrary.wiley.com/termsAndConditions#vor |
op_doi |
https://doi.org/10.1111/aogs.13108 |
container_title |
Acta Obstetricia et Gynecologica Scandinavica |
container_volume |
96 |
container_issue |
5 |
container_start_page |
607 |
op_container_end_page |
616 |
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1812178037661237248 |