[Cesarean section in the Burgundy perinatal network: reasons for differences in the management of mothers].
OBJECTIVE
The aim of our study is to determine the relative risk of cesarean section at term induced by medical, organizational and personal factors in a regional healthcare network.


METHODS
Our retrospective study covered all 17,062 full-term births, not including pre-birth transfers, in the 20 maternity hospitals of Burgundy in 2001. Statistical analysis was performed on the data collected, which was exhaustive and validated for all 18,278 births of our perinatal network.


RESULTS
The percentage of cesarean sections performed at term was 16.4% (overall percentage of cesarean sections was 17.5%, equivalent to our national rate in 1998). But there was significant inverse relationship between the percentage of cesarean sections and the level of our maternity hospitals (17.4, 16.1 and 14.1% for types I, II, and III respectively). And 4 of our 20 establishments had a higher rate of ceasarean sections, with no medical justification.


CONCLUSIONS
Our study shows that for a pregnant woman at term, the simple fact of benefiting from care in such a maternity hospital corresponds to a risk factor for cesarean section (OR = 1.9), which is higher than IUGR (OR = 1.6) diabetes (OR = 1.6) or macrosomia (OR = 1.3). It also shows the feasibility of such an objective analysis of medical practices, providing that data collection is exhaustive and validated for the whole population of the perinatal network, and providing that it includes medical, organizational and personal factors.
Sagot
P
P
Service de gynécologie-obstétrique, médecine foetale et reproduction humaine, CHU de Dijon, 10, boulevard du Maréchal-de-Lattre-de-Tassigny, BP 77908, 21079 Dijon, France. paul.sagot@chu-dijon.fr
Gouyon-Cornet
B
B
Gouyon
J B
JB
D002585:Cesarean Section / Q000706:statistics & numerical data*; D005260:Female; D005602:France / Q000453:epidemiology; D006771:Hospitals, Maternity; D006801:Humans; D007231:Infant, Newborn; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors