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Table 3 Prevalence of complications of pregnancy and labour with a higher risk for caesarean section by region and year (all hospital births in the GePaRD) (% with a given diagnosis)

From: Regional variation in caesarean deliveries in Germany and its causes

  Former East Germany Former West Germany By year By region
  2004a 2005 2006f 2004a 2005 2006f   
Diagnosesb % % % % % % p-valuee p-valuee
Twins and higher order pregnancies 1.86 1.64 1.64 2.02 1.73 1.92 0.0506 0.0101
Anomalies of the foetal presentation 9.42 9.81 9.57 9.71 9.85 10.12 0.0100 0.0497
Intrauterine growth restriction 3.33 3.49 3.88 3.39 3.69 4.19 <.0001 0.0376
Post date pregnancy 15.85 16.64 16.66 13.62 15.10 14.73 <.0001 <.0001
Preterm delivery 7.58 7.31 7.38 7.69 7.59 7.36 0.0155 0.3190
Maternal distress 0.55 0.50 0.71 0.47 0.51 0.41 0.5211 0.0005
Obstructed labour 1.15 1.01 1.02 1.39 1.61 1.45 0.6837 <.0001
Asphyxia 20.92 22.56 23.63 19.30 20.59 20.88 <.0001 <.0001
Prolonged birth 8.07 7.77 7.48 9.62 10.08 10.19 0.0087 <.0001
Macrosomia 1.57 1.69 1.79 1.33 1.38 2.17 <.0001 0.2974
Placenta praevia 0.36 0.41 0.49 0.52 0.51 0.51 0.5895 0.0086
Abruptio placentae 0.50 0.56 0.48 0.64 0.54 0.58 0.1963 0.0582
Disproportion 2.29 2.15 2.18 3.57 3.30 3.40 0.0506 <.0001
Anomalies of maternal pelvis 10.25 9.62 9.73 13.03 13.69 14.24 <.0001 <.0001
Intrapartal bleeding (excluding placenta previa) 0.34 0.30 0.46 0.39 0.58 0.56 <.0001 <.0001
Failed induction 1.00 0.94 0.98 0.95 1.19 1.31 <.0001 0.0006
Preexisting hypertonic disorders 0.39 0.44 0.44 0.31 0.33 0.34 0.2226 0.0013
Non-severe hypertonic disorders during pregnancy 3.76 3.83 3.79 3.06 3.34 3.39 0.0013 <.0001
Preeclampsia 3.21 3.32 3.19 3.04 2.99 2.89 0.1234 0.0015
Eclampsia 0.17 0.08 0.13 0.15 0.13 0.13 0.1504 0.5808
Complications because of umbilical cord 10.25 11.00 11.40 9.29 9.95 10.15 <.0001 <.0001
Diabetes mellitus 0.42 0.39 0.33 0.39 0.36 0.40 0.8311 0.9695
Gestational diabetes mellitus 1.97 2.28 2.45 3.44 3.72 3.77 <.0001 <.0001
Uterine rupture 0.18 0.15 0.21 0.28 0.26 0.26 0.4876 0.0005
Premature rupture of foetal membranes (PROM) 19.51 20.18 20.40 19.33 20.24 20.50 <.0001 0.9789
Abnorm contractions 6.33 6.97 6.51 4.89 5.41 5.22 0.0037 <.0001
Previous caesarean section 5.14 4.94 4.77 7.36 7.88 8.36 <.0001 <.0001
At least one strongc indication for caesarean section 12.35 12.68 12.43 14.12 13.91 14.32 0.2773 <.0001
At least one of the moderated indications for caesarean section 58.33 60.06 60.98 56.65 59.71 59.99 <.0001 <.0001
Patients with no indication of diagnoses which could justify caesarean section 29.31 27.26 26.59 29.23 26.39 25.69 <.0001 0.0041
  1. a Restricted to births from February till December.
  2. b The same patient could have several of the listed diagnoses.
  3. c As strong indications were classified: Placenta praevia, Abruptio placentae, Uterine rupture, anomalies of foetal presentation and disproportion [11].
  4. d All indications listed in the table and not classified as strong were classified as moderate.
  5. e p-values obtained from logistic regression simultaneously adjusting for time trends and regional differences.
  6. f Restricted to births from January till November.