Cesarean delivery in Iran: a population-based analysis using the Robson classification system

Abstract

Background The rise of Cesarean Sections (CS) is a global concern. In Iran, the rate of CS increased from 40.7% in 2005 to 53% in 2014. This figure is even higher in the private sector. Objective To analyze the CS rates in the last 2 years using the Robson Classification System in Iran. Methods A retrospective analysis of all in-hospital electronically recorded deliveries in Iran was conducted using the Robson classification. Comparisons were made in terms of the type of hospital, CS rate, and obstetric population, and contributions of each group to the overall cesarean deliveries were reported. Results Two million three hundred twenty-two thousand five hundred women gave birth, 53.6% delivered through CS. Robson group 5 was the largest contributing group to the overall number of cesarean deliveries (47.1%) at a CS rate of 98.4%. Group 2 and 1 ranked the second and third largest contributing groups to overall CSs (20.6 and 10.8%, respectively). The latter groups had CS rates much higher than the WHO recommendation of 67.2 and 33.1%, respectively. “Fetal Distress” and “Undefined Indications” were the most common reasons for cesarean deliveries at CS rates of 13.6 and 13.4%, respectively. There was a significant variation in CS rate among the three types of hospitals for Robson groups 1, 2, 3, 4, and 10. Conclusion The study revealed significant variations in CS rate by hospital peer-group, especially for the private maternity units, suggesting the need for further attention and audit of the Robson groups that significantly influence the overall CS rate. The study results will help policymakers identify effective strategies to reduce the CS rate in Iran, providing appropriate benchmarking to compare obstetric care with other countries that have better maternal and perinatal outcomes.

The incidence of congenital anomalies in newborns before and during the Covid-19 pandemic

“…It records all birth-related data electronically (demographics, maternal characteristics, medical history, obstetric interventions, pregnancy complications, and perinatal outcomes) across the country since 2013. The national accreditation program confirmed that there is acceptable validity and reliability in the recent years with more than 95% of the registration rate [5]. Almost from the beginning of online birth registry in Iran (2013), surveillance of birth defects has been started.…”

The trend of normal vaginal delivery and cesarean sections before and after implementing the health system transformation plan based on ICD‐10 in the northeast of Iran: A cross‐sectional study

“…According to the WHO report, the CS rate should not exceed 15% of all deliveries 8 . However, research has reported a higher CS incidence in Iran 9 . Despite the declining trend in MMR in Iran from 1990 to 2013, CS outcomes still account for most maternal mortality in the country 2 .…”

Knowledge, attitude and practice of healthcare providers on mistreatment during labour and childbirth: a cross-sectional study in Tehran, Iran, 2021

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