Rate of and factors associated with indications for cesarean deliveries: Results of a national review in Burkina Faso.
OBJECTIVE
To determine the prevalence of cesarean deliveries in Burkina Faso, analyze the indications for them and the outcomes, and identify factors associated with non-absolute maternal indications for the procedure, as opposed to major obstetric interventions performed to save a woman's life.


METHODS
In a cross-sectional study, we selected and analyzed cesarean deliveries among those most recently performed between May 2009 and April 2010 in all facilities in Burkina Faso. To identify the factors associated with non-absolute maternal indications, we used generalized estimating equations to take into account the clustering of data at the hospital level.


RESULTS
The proportion of births by cesarean delivery was 1.5%, with regional variations ranging from 0.8% to 4.5%. They were performed mainly for absolute maternal indications (54.8%). Cesarean deliveries for non-absolute maternal indications were statistically more frequent in private hospitals (OR 2.2; 95% CI, 1.2-4.0), among women in urban areas (OR 1.6; 95% CI, 1.0-2.4), during scheduled cesareans, and in the absence of use of the partogram.


CONCLUSIONS
This study confirms the small proportion of cesarean deliveries in Burkina, the disparity between urban and rural areas, and the relative preponderance of absolute maternal indications for cesarean delivery.
Biomedical and Public Health Department, Research Institute of Health Sciences, Ouagadougou, Burkina Faso; African Institute of Public Health, Ouagadougou, Burkina Faso. Electronic address: medabert@yahoo.fr.
Ivlabèhiré Bertrand
IB
Meda
African Institute of Public Health, Ouagadougou, Burkina Faso.
Tieba
T
Millogo
Biomedical and Public Health Department, Research Institute of Health Sciences, Ouagadougou, Burkina Faso.
Adama
A
Baguiya
Biomedical and Public Health Department, Research Institute of Health Sciences, Ouagadougou, Burkina Faso.
Laeticia
L
Ouédraogo/Nikiema
Biomedical and Public Health Department, Research Institute of Health Sciences, Ouagadougou, Burkina Faso.
Abou
A
Coulibaly
Biomedical and Public Health Department, Research Institute of Health Sciences, Ouagadougou, Burkina Faso; African Institute of Public Health, Ouagadougou, Burkina Faso.
Seni
S
Kouanda
D000328:Adult; D002050:Burkina Faso; D002585:Cesarean Section / Q000706:statistics & numerical data*; D004632:Emergency Medical Services / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007744:Obstetric Labor Complications / Q000453:epidemiology* / Q000601:surgery; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology*; D017149:Private Sector / Q000706:statistics & numerical data; D017150:Public Sector / Q000706:statistics & numerical data; D055815:Young Adult
Burkina Faso; Cesarean delivery; Emergency obstetrics; Indications; Maternal health; Neonatal care