title: Caesarean delivery before 39 weeks associated with selecting an auspicious time for birth in Taiwan.
abstract: BACKGROUND
  Caesarean delivery before 39 weeks of gestation increases the risk of morbidity among infants. Taiwan has one of the highest caesarean rates in the world, but little attention has been paid to this issue. This study aimed to describe the rate of caesarean delivery before 39 weeks gestation among women who did not have labour signs and had a non-emergency caesarean delivery in Taiwan and to examine whether the phenomenon was associated with the Chinese cultural practice of selecting an auspicious time for birth.
  
  
  METHODS
  We recruited women at 15-28 weeks of pregnancy at 5 hospitals in northern Taiwan and followed them at 4 or 5 weeks after delivery using structured questionnaires. This analysis included 150 primiparous mothers with a singleton pregnancy who had a non-emergency caesarean delivery without the presence of labour signs.
  
  
  RESULTS
  Ninety-three of these women (62.0%) had caesarean deliveries before 39 weeks of gestation. Logistic regression analysis showed that women who had selected an auspicious time for delivery (OR=2.82, 95% CI: 1.15-6.95) and delivered in medical centres (OR=5.26, 95% CI: 2.25-12.26) were more likely to deliver before 39 weeks of gestation.
  
  
  CONCLUSIONS
  Non-emergency caesarean delivery before 39 weeks of gestation was common among the study women, and was related to the Chinese cultural practice of selecting an auspicious time for birth. Further studies are needed to examine the risks and benefits associated with timing of caesarean delivery in Taiwan in order to generate a consensus among obstetricians and give pregnant women appropriate information.
authors: Department of Nursing, National Yang-Ming University, Taipei, Taiwan; Ching Kuo Institute of Management and Health, Keelung, Taiwan. Electronic address: kueihuichu@gmail.com.
authors: Kuei-Hui
authors: KH
authors: Chu
authors: Department of Obstetrics and Gynecology, Buddhist Tzu Chi General Hospital, Taipei Branch, Taipei, Taiwan. Electronic address: A_101338@tzuchi.com.tw.
authors: Yu-Hsiang
authors: YH
authors: Lee
authors: Department of Obstetrics and Gynecology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; Department of Traditional Chinese Medicine, Taipei Medical University Hospital, Taipei, Taiwan. Electronic address: chenjtai@tmu.edu.tw.
authors: Chen-Jei
authors: CJ
authors: Tai
authors: Department of Obstetrics and Gynecology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; Department of Obstetrics and Gynecology, Shin-Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan; School of Medicine, Fu-Jen Catholic University, New Taipei City, Taiwan; Department of Obstetrics and Gynecology, National Taiwan University Hospital, Taipei, Taiwan. Electronic address: M002179@ms.skh.org.tw.
authors: Yu-Hung
authors: YH
authors: Lin
authors: Department of Nursing, National Yang-Ming University, Taipei, Taiwan. Electronic address: cmhuang@ym.edu.tw.
authors: Chiu-Mieh
authors: CM
authors: Huang
authors: Institute of Clinical and Community Health Nursing, National Yang-Ming University, Taipei, Taiwan. Electronic address: lychien@ym.edu.tw.
authors: Li-Yin
authors: LY
authors: Chien
mesh_terms: D000328:Adult; D002585:Cesarean Section / Q000706:statistics & numerical data*; D003657:Decision Making; D036861:Delivery, Obstetric / Q000706:statistics & numerical data; D017558:Elective Surgical Procedures / Q000706:statistics & numerical data*; D005260:Female; D005865:Gestational Age; D006801:Humans; D036801:Parturition; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology*; D013624:Taiwan / Q000453:epidemiology; D055815:Young Adult
keywords: Caesarean delivery; Childbirth; Culture; Gestational age; Obstetric deliveries