title: Decrease in perinatal mortality and increase in cesarean section rates.
abstract: OBJECTIVE
  To investigate the cesarean section (CS) rate in the Riyadh area, its trend and relationship to perinatal mortality (PNM).
  
  
  METHODS
  Based on delivery data obtained from the Ministry of Health hospitals, Saudi Arabia, for a total of 12 years, yearly rates of CS, PNM and the ratios of obstetricians and beds per 10,000 population were computed for the Riyadh area and compared with the overall rates for Saudi Arabia. Correlation coefficients were used to investigate the relationship between the CS rate and each of the stated variables.
  
  
  RESULTS
  Riyadh had significantly lower rates of CS and PNM than Saudi Arabia as a whole. The CS rate in Riyadh showed a positive trend (increasing from 4.4 to 6.7%) while the PNM rate revealed a significant decreasing trend (decreasing from 21.6/1000 to 16/1000 live births). A negative association existed between the Riyadh rates of PNM and CS (r = -0.2375) and PNM and the availability of obstetricians (r = -0.8693).
  
  
  CONCLUSIONS
  From our data it was not possible to establish a cause and effect relationship between the CS and PNM rates.
authors.affiliation: Department of Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia.
authors.forename: A I
authors.initials: AI
authors.lastname: Shehata
authors.forename: T J
authors.initials: TJ
authors.lastname: Hashim
mesh_terms: D002585:Cesarean Section / Q000706:statistics & numerical data* / Q000639:trends; D005260:Female; D006801:Humans; D007226:Infant Mortality / Q000639:trends; D007231:Infant, Newborn; D011247:Pregnancy; D012529:Saudi Arabia / Q000453:epidemiology