title: Caesarean delivery in the Limbé and the Buea regional hospitals, Cameroon: frequency, indications and outcomes.
abstract: BACKGROUND
  Neonatal outcomes can be directly and indirectly affected by caesarean delivery (CD). Data on CD rates in semi-urban and rural hospitals in resource-limited settings are scarce and yet are needed to better guide the care of women and neonates in these settings. we carried out this study to determine the frequency of CD, its indications and the frequency of the various adverse neonatal outcomes (ANO) in the Limbe Regional Hospital (LRH) and the Buea Regional Hospital (BRH), Cameroon. We also assessed the relationship between the indication for CD and ANO in the said hospitals.
  
  
  METHODS
  This was a hospital-based retrospective and prospective cross-sectional study using descriptive and analytic methods conducted in the LRH and the BRH maternity units within a nine months period in 2015. Informed consent was obtainedfrom mothers of the neonates. Data analyses were performed using Epi-Info 3.5.4 software.
  
  
  RESULTS
  We recruited 199 neonates born through CD. The prevalence of CD was 13.3% with cephalopelvic disproportion (CPD) being the most frequent (32.2%) indication for CD. There were 52 (26.1%) ANO following CD and respiratory distress was the most common 24 (46.2%) of all ANO. Emergency indications for CD were associated with more ANO 49 (34.5%) as compared to elective indications for CD 3 (5.3%) [p-value<0.001]. We noted a significant association between indications for CD and the various type of ANO, with CPD having the worse prognostic neonatal outcomes 30.8% [p-value=0.02].
  
  
  CONCLUSIONS
  The prevalence of ANO associated with CD in our hospitals was high with a worrying prognosis. While the exact reasons are unknown, the creation of well-equipped neonatal units with trained staff, may contribute to reduce neonatal morbidity and fatalities. Furthermore, the association of CPD to worse prognostic neonatal outcomes calls for clinicians, to consider additional management options, such as antibiotic prophylaxis and oxygen therapy to the neonates, prior to CD.
authors: Department of Paediatrics and Obstetrics/Gynecology Limbé Regional Hospital, Limbe, Cameroon.
authors: Tanyi John
authors: TJ
authors: Tanyi
authors: Department of Public Health and Hygiene, Faculty of Health Sciences, University of Buea, Buea, Cameroon.
authors: Julius
authors: J
authors: Atashili
authors: Department of Public Health and Hygiene, Faculty of Health Sciences, University of Buea, Buea, Cameroon.
authors: Peter Nde
authors: PN
authors: Fon
authors: Department of Obstertrics/Gynecology, Limbé Regional Hospital, Limbe, Cameroon.
authors: Tchounzou
authors: T
authors: Robert
authors: Department of paediatrics, Faculty of Medicine and Biomedical Sciences, University of Yaounde, Yaounde, Cameroon.
authors: Koki Ndombo
authors: KN
authors: Paul
mesh_terms: D000293:Adolescent; D000328:Adult; D002163:Cameroon; D052178:Cephalopelvic Disproportion / Q000453:epidemiology*; D002585:Cesarean Section / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D017558:Elective Surgical Procedures / Q000706:statistics & numerical data; D004630:Emergencies; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D011247:Pregnancy; D011256:Pregnancy Outcome; D015995:Prevalence; D011379:Prognosis; D011446:Prospective Studies; D012189:Retrospective Studies; D055815:Young Adult
keywords: Caesarean delivery; adverse neonatal outcome; prevalence; resource-limited settings