title: Determinants of Caesarean Risk Factor in Northern Region of Bangladesh: A Multivariate Analysis.
abstract: BACKGROUND
  Caesarean section (c-section) rates have been increasing dramatically in the past decades around the world. This increase has been attributed to multiple factors such as maternal, socio-demographic and institutional fac-tors. Therefore, this study examines the impact of maternal, socio-demographic and relevant characteristics on caesar-ean delivery in the northern region of Bangladesh.
  
  
  METHODS
  This study is based on a total of 1142 delivery cases from four private hospitals and four public hospitals during the period of January to March 2010. The study was carried out using a cross-sectional design where data were collected by simple random sampling. In order to data analysis, first, an initial bivariate analysis was performed by the chi-square and Fisher exact test. Secondly, the risk factors which are associated with c-section identify by logistic re-gression model. Finally, a stepwise regression analysis was carried out to isolate the most influential risk factors.
  
  
  RESULTS
  Among the 17 risk factors, nine were found significantly associated with type of delivery. Eight of the risk factors i.e. previous c-section, pregnancy-induced swollen of leg, prolonged labour, maternal education status, mater-nal age more than 25 years, low birth order, length of baby more than 45cm and irregular intake of a balanced diet remained independently significant for caesarean delivery. The value of P<0.05 was considered statistically significant. Maternal complications were found to be more significant in public hospitals than in private ones and conversely for the demographic characteristics.
  
  
  CONCLUSIONS
  The findings of this study suggested that the above factors may influence the health-seeking behaviour of women in the northern region of Bangladesh.
authors.affiliation: 1. Institute of Graduate Studies, University of Malaya, Malaysia.
authors.forename: Mostafizur
authors.initials: M
authors.lastname: Rahman
authors.affiliation: 2. Centre for Foundation Studies in Science, University of Malaya, Malaysia.
authors.forename: Asma
authors.initials: A
authors.lastname: Ahmad Shariff
authors.affiliation: 3. Dept. of Geography, University of Malaya, Malaysia.
authors.forename: Aziz
authors.initials: A
authors.lastname: Shafie
authors.affiliation: 4. Dept. of Obstetrics and Gynecology, University of Malaya, Malaysia.
authors.forename: Rahmah
authors.initials: R
authors.lastname: Saaid
authors.affiliation: 2. Centre for Foundation Studies in Science, University of Malaya, Malaysia.
authors.forename: Rohayatimah
authors.initials: R
authors.lastname: Md Tahir
keywords: Caesarean delivery; Multiple logistic regression; Risk factors; Stepwise regression analysis