title: Caesarean deliveries in the Mother-Child (Rhea) cohort in Crete, Greece: almost as frequent as vaginal births and even more common in first-time mothers.
abstract: BACKGROUND
  Caesarean deliveries are on the increase in Greece and around the world. The objective of the present study was to assess the frequency of planned and emergency caesarean deliveries and their socio-demographic predictors in women with singleton pregnancies followed-up from early pregnancy to delivery.
  
  
  METHODS
  The mother-child cohort in Crete examines a population sample of pregnant women recruited during one year beginning in February 2007. A cohort of 1096 women, with singleton pregnancies, was included in the present analyses. Multivariable Poisson regression models with robust error variance were used.
  
  
  RESULTS
  Overall, 48% of the women had a caesarean delivery, with a higher percentage observed in women having their first child (52%). Maternal age was a predictor for caesarean deliveries; type of hospital was associated with the risk for an emergency caesarean, whereas women with lower education were at an increased risk of having a planned caesarean delivery among primiparae. Prior caesarean delivery was by far the strongest predictor (RR=7.68, 95% CI 5.71, 10.33) for a subsequent one among multiparae.
  
  
  CONCLUSIONS
  Caesarean deliveries are almost as frequent as vaginal births in the study population and even more frequent in first-time mothers. The study findings support that risk factors are indeed mode of delivery and parity status specific. As such, it is becoming clearer which groups of women, especially first-time mothers, need to be targeted in future research and interventions so as to understand better and achieve an appropriate caesarean delivery risk.
authors.affiliation: Department of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Greece. ; Department of Neurology and Division of Epidemiology, Mayo Clinic, Rochester, MN, USA.
authors.forename: M
authors.initials: M
authors.lastname: Vassilaki
authors.affiliation: Department of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Greece.
authors.forename: L
authors.initials: L
authors.lastname: Chatzi
authors.affiliation: Department of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Greece.
authors.forename: M
authors.initials: M
authors.lastname: Rasidaki
authors.affiliation: Institute of Child Health (UCL), London, UK.
authors.forename: E
authors.initials: E
authors.lastname: Bagkeris
authors.affiliation: Department of Nursing, Technological Educational Institute (TEI) of Crete, Greece.
authors.forename: G
authors.initials: G
authors.lastname: Kritsotakis
authors.affiliation: Department of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Greece.
authors.forename: T
authors.initials: T
authors.lastname: Roumeliotaki
authors.affiliation: Department of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Greece.
authors.forename: A
authors.initials: A
authors.lastname: Koutis
authors.affiliation: Department of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Greece.
authors.forename: A
authors.initials: A
authors.lastname: Philalithis
authors.affiliation: Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain ; IMIM (Hospital del Mar Research Institute), Barcelona, Spain ; CIBER Epidemiologia y Salud Pública (CIBERESP), Barcelona, Spain ; National School of Public Health, Athens, Greece.
authors.forename: M
authors.initials: M
authors.lastname: Kogevinas
keywords: Caesarean delivery; delivery mode; emergency caesarean delivery; planned caesarean delivery