About this Journal Submit a Manuscript Table of Contents
BioMed Research International
Volume 2013 (2013), Article ID 786563, 9 pages
http://dx.doi.org/10.1155/2013/786563
Research Article

Interinstitutional Variation of Caesarean Delivery Rates According to Indications in Selected Obstetric Populations: A Prospective Multicenter Study

1Multicenter Study Group on Mode of Delivery in Friuli Venezia Giulia, Institute for Maternal and Child Health (IRCSS) Burlo Garofolo, 34137 Trieste, Italy
2Department of Obstetrics and Gynecology, Institute for Maternal and Child Health (IRCCS) Burlo Garofolo, 34137 Trieste, Italy
3Epidemiology and Biostatistics Unit, Institute for Maternal and Child Health (IRCCS) Burlo Garofolo, 34137 Trieste, Italy
4Department of Obstetrics and Gynecology, Hospital of Gorizia, 34170 Gorizia, Italy
5Department of Obstetrics and Gynecology, Hospital of Latisana, 33053 Latisana, Italy
6Department of Obstetrics and Gynecology, Hospital of Palmanova, 33100 Palmanova, Italy
7Department of Obstetrics and Gynecology, Hospital of Monfalcone, 34070 Monfalcone, Italy
8Department of Obstetrics and Gynecology, S. Giorgio Hospital, 33170 Pordenone, Italy
9Department of Obstetrics and Gynecology, S. Maria degli Angeli Hospital, 33170 Pordenone, Italy
10Department of Obstetrics and Gynecology, Hospital of S. Daniele del Friuli, 33038 S. Daniele del Friuli, Italy
11Department of Obstetrics and Gynecology, S. Maria dei Battuti Hospital, 33078 S. Vito al Tagliamento, Italy
12Department of Obstetrics and Gynecology, S. Antonio Abate Hospital, 33028 Tolmezzo, Italy
13Department of Obstetrics and Gynecology, S. Maria della Misericordia Hospital, University of Udine, 33100 Udine, Italy
14Department of Neonatology and Neonatal Intensive Care, Institute for Maternal and Child Health (IRCCS) Burlo Garofolo, 34137 Trieste, Italy
15Regional Health Agency of Friuli Venezia Giulia, 33100 Udine, Italy
16Department of Statistics and Programming, University La Sapienza, 00185 Rome, Italy
17Research Direction, Institute for Maternal and Child Health (IRCCS) Burlo Garofolo, 34137 Trieste, Italy

Received 24 April 2013; Revised 3 June 2013; Accepted 3 June 2013

Academic Editor: Kaei Nasu

Copyright © 2013 Gianpaolo Maso et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

The aim of the study was to identify which groups of women contribute to interinstitutional variation of caesarean delivery (CD) rates and which are the reasons for this variation. In this regard, 15,726 deliveries from 11 regional centers were evaluated using the 10-group classification system. Standardized indications for CD in each group were used. Spearman’s correlation coefficient was used to calculate (1) relationship between institutional CD rates and relative sizes/CD rates in each of the ten groups/centers; (2) correlation between institutional CD rates and indications for CD in each of the ten groups/centers. Overall CD rates correlated with both CD rates in spontaneous and induced labouring nulliparous women with a single cephalic pregnancy at term ( ). Variation of CD rates was also dependent on relative size and CD rates in multiparous women with previous CD, single cephalic pregnancy at term ( ). As for the indications, “cardiotocographic anomalies” and “failure to progress” in the group of nulliparous women in spontaneous labour and “one previous CD” in multiparous women previous CD correlated significantly with institutional CD rates ( , , and , resp.). These results supported the conclusion that only selected indications in specific obstetric groups accounted for interinstitutional variation of CD rates.