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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.
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BMC Pregnancy and Childbirth

ISSN: 1471-2393

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