title: Interinstitutional variation of caesarean delivery rates according to indications in selected obstetric populations: a prospective multicenter study.
abstract: The aim of the study was to identify which groups of women contribute to interinstitutional variation of caesarean delivery (CD) rates and which are the reasons for this variation. In this regard, 15,726 deliveries from 11 regional centers were evaluated using the 10-group classification system. Standardized indications for CD in each group were used. Spearman's correlation coefficient was used to calculate (1) relationship between institutional CD rates and relative sizes/CD rates in each of the ten groups/centers; (2) correlation between institutional CD rates and indications for CD in each of the ten groups/centers. Overall CD rates correlated with both CD rates in spontaneous and induced labouring nulliparous women with a single cephalic pregnancy at term (P = 0.005). Variation of CD rates was also dependent on relative size and CD rates in multiparous women with previous CD, single cephalic pregnancy at term (P < 0.001). As for the indications, "cardiotocographic anomalies" and "failure to progress" in the group of nulliparous women in spontaneous labour and "one previous CD" in multiparous women previous CD correlated significantly with institutional CD rates (P = 0.021, P = 0.005, and P < 0.001, resp.). These results supported the conclusion that only selected indications in specific obstetric groups accounted for interinstitutional variation of CD rates.
authors.affiliation: Multicenter Study Group on Mode of Delivery in Friuli Venezia Giulia, Institute for Maternal and Child Health (IRCSS) Burlo Garofolo, 34137 Trieste, Italy. gianpaolo.maso@burlo.trieste.it
authors.forename: Gianpaolo
authors.initials: G
authors.lastname: Maso
authors.forename: Monica
authors.initials: M
authors.lastname: Piccoli
authors.forename: Marcella
authors.initials: M
authors.lastname: Montico
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Monasta
authors.forename: Luca
authors.initials: L
authors.lastname: Ronfani
authors.forename: Sara
authors.initials: S
authors.lastname: Parolin
authors.forename: Carmine
authors.initials: C
authors.lastname: Gigli
authors.forename: Daniele
authors.initials: D
authors.lastname: Domini
authors.forename: Claudio
authors.initials: C
authors.lastname: Fiscella
authors.forename: Sara
authors.initials: S
authors.lastname: Casarsa
authors.forename: Carlo
authors.initials: C
authors.lastname: Zompicchiatti
authors.forename: Michela
authors.initials: M
authors.lastname: De Agostini
authors.forename: Attilio
authors.initials: A
authors.lastname: D'Atri
authors.forename: Raffaela
authors.initials: R
authors.lastname: Mugittu
authors.forename: Santo
authors.initials: S
authors.lastname: La Valle
authors.forename: Cristina
authors.initials: C
authors.lastname: Di Leonardo
authors.forename: Valter
authors.initials: V
authors.lastname: Adamo
authors.forename: Mara
authors.initials: M
authors.lastname: Fracas
authors.forename: Giovanni
authors.initials: G
authors.lastname: Del Frate
authors.forename: Monica
authors.initials: M
authors.lastname: Olivuzzi
authors.forename: Silvio
authors.initials: S
authors.lastname: Giove
authors.forename: Maria
authors.initials: M
authors.lastname: Parente
authors.forename: Daniele
authors.initials: D
authors.lastname: Bassini
authors.forename: Simona
authors.initials: S
authors.lastname: Melazzini
authors.forename: Secondo
authors.initials: S
authors.lastname: Guaschino
authors.forename: Caterina
authors.initials: C
authors.lastname: Businelli
authors.forename: Franco G
authors.initials: FG
authors.lastname: Toffoletti
authors.forename: Diego
authors.initials: D
authors.lastname: Marchesoni
authors.forename: Alberto
authors.initials: A
authors.lastname: Rossi
authors.forename: Sergio
authors.initials: S
authors.lastname: Demarini
authors.forename: Laura
authors.initials: L
authors.lastname: Travan
authors.forename: Giorgio
authors.initials: G
authors.lastname: Simon
authors.forename: Sandro
authors.initials: S
authors.lastname: Zicari
authors.forename: Giorgio
authors.initials: G
authors.lastname: Tamburlini
authors.forename: Salvatore
authors.initials: S
authors.lastname: Alberico
mesh_terms: D000047:Academies and Institutes / Q000706:statistics & numerical data*; D000328:Adult; D002585:Cesarean Section / Q000379:methods* / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007558:Italy / Q000453:epidemiology; D011247:Pregnancy; D011446:Prospective Studies