Cesarean-section Rates in Brazil from 2014 to 2016: Cross-sectional Analysis Using the Robson Classification

Abstract

Objective To obtain cesarean-section (CS) rates according to the Robson Group Classification in five different regions of Brazil.

Methods A descriptive epidemiological study using data from secondary birth records from the Computer Science Department of the Brazilian Unified Health System (Datasus, in Portuguese) between January 1st, 2014, and December 31st, 2016, including all live births in Brazil.

Results The overall rate of CS was of 56%. The sample was divided into 11 groups, and vaginal births were more frequent in groups 1 (53.6%), 3 (80.0%) and 4 (55.1%). The highest CS rates were found in groups 5 (85.7%), 6 (89.5%), 7 (85.2%) and 9 (97.0%). The overall CS rate per region varied from 46.2% in the North to 62.1% in the Midwest. Group 5 was the largest obstetric population in the South, Southeast and Midwest, and group 3 was the largest in the North and Northeast. Group 5 contributed the most to the overall CS rate, accounting for 30.8% of CSs.

Conclusion Over half of the births in Brazil were cesarean sections. The Midwest had the highest CS rates, while the North had the lowest. The largest obstetric population in the North and in the Northeast was composed of women in group 3, while in the South, Southeast and Midwest it was group 5. Among all regions, the largest contribution to the overall CS rate was from group 5.

Resumo

Objetivo Identificar as taxas de cesárea de acordo com a Classificação de Robson nas cinco regiões do Brasil.

Métodos Estudo epidemiológico descritivo utilizando dados secundários obtidos do Departamento de Informática do Sistema Único de Saúde (Datasus) entre 1° de janeiro de 2014 e 31 de dezembro de 2016, incluindo todos os nascidos vivos no Brasil.

Resultados Cesáreas representaram 56% de todos os nascimentos. A amostra foi dividida em 11 grupos, e partos vaginais foram mais frequentes nos grupos 1 (53,6%), 3 (80,0%) e 4 (55,1%). As maiores taxas de cesárea foram encontradas nos grupos 5 (85,7%), 6 (89,5%), 7 (85,2%) e 9 (97,0%). A taxa geral de cesárea variou de 46,2% no Norte a 62,1% no Centro-Oeste. O grupo 5 representou a maior população obstétrica no Sul, Sudeste e Centro-Oeste, e o grupo 3, no Norte e Nordeste. O grupo 5 contribuiu mais para a taxa geral de cesárea, totalizando 30,8%.

Conclusão Mais da metade dos nascimentos no Brasil ocorreu por cesárea. O Centro-Oeste apresentou a maior taxa, e o Norte, a mais baixa. A maior população obstétrica no Norte e no Nordeste foi o grupo 3, enquanto no Sul, Sudeste e Centro-Oeste foi o grupo 5. Entre todas as regiões, a maior contribuição para a taxa geral de cesárea foi do grupo 5.

Keywords

cesarean section - vaginal birth after cesarean section - obstetric delivery - repeat cesarean section - induced labor

Palavras-chave

cesárea - nascimento vaginal após cesárea - parto obstétrico - cesárea repetida - trabalho de parto induzido

Contributors

Roxana Knobel worked on the conceptualization and design of the study, on data collection and analysis, drafted the manuscript, critically reviewed and revised the manuscript, and approved the final version to be submitted. Thiago Jose Pinheiro Lopes worked on the conceptualization and design of the study, on data collection and analysis, drafted the manuscript, critically reviewed and revised the manuscript, and approved the final version to be submitted. Mariane de Oliveira Menezes worked on analysis and interpretation of data, as well as writing of the article, critical review of the intellectual content, and final approval of the version to be published. Carla Betina Andreucci worked on analysis and interpretation of data, as well as writing of the article, critical review of the intellectual content, and final approval of the version to be published. Juliana Toledo Gieburowski worked on analysis and interpretation of data, as well as writing of the article, critical review of the intellectual content, and final approval of the version to be published. Maira Libertad Soligo Takemoto worked on analysis and interpretation of data, as well as writing of the article, critical review of the intellectual content, and final approval of the version to be published. All authors have made substantive contributions to the present manuscript, and all have reviewed the final paper prior to its submission.

Publication History

Received: 12 January 2020

Accepted: 30 March 2020

Article published online:
19 June 2020

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