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Table 3 Summary of women-, obstetric-, labor-, and facility-level factors by adverse outcomes associated with intrapartum cesarean birth, WHOGS 2004–2008

From: Risk factors associated with adverse maternal outcomes following intrapartum cesarean birth: a secondary analysis of the WHO global survey on maternal and perinatal health, 2004–2008

 

No Adverse Outcomes

(n = 28,476)

Adverse Outcomes

(n = 1040)

All

(n = 29,516)

Woman-Level Factors

Human Development Index 2008 of Country in Which Woman Delivered

  Lowa

1394

5%

164

16%

1558

5%

  Mediumb

20,977

74%

801

77%

21,778

74%

  Highc

6105

21%

75

7%

6180

21%

Antenatal Visits

  < 4 visits

6211

22%

350

34%

6561

22%

  4+ visits

20,489

72%

625

60%

21,114

72%

  Missing

1776

6%

65

6%

1841

6%

Medically high riskd

  No

22,803

80%

2370

813

25,173

81%

  Yes

5283

19%

342

217

5625

18%

  Missing

390

1%

10

0%

400

1%

Age groups

  0–18

2016

7%

71

7%

2087

7%

  19–34

23,210

82%

771

74%

23,981

81%

  35+

3222

11%

189

18%

3411

12%

  Missing

28

0%

9

1%

37

0%

Education groups

  0–6 years

6065

21%

308

30%

6373

22%

  7–12 years

15,835

56%

541

52%

16,376

55%

  13+ years

4991

18%

128

12%

5119

17%

  Missing

1585

6%

63

6%

1648

6%

Marital status

  Single/Separated/Divorced/Widowed/Other

3525

12%

123

12%

3648

12%

  Married/Cohabitating

24,852

87%

917

88%

25,769

87%

  Missing

99

0%

0

0%

99

0%

BMI groups

  Underweight

147

1%

6

1%

153

1%

  Normal weight

7950

28%

265

25%

8215

28%

  Overweight

11,128

39%

355

34%

11,483

39%

  Obese

4860

17%

197

19%

5057

17%

  Missing

4391

15%

217

21%

4608

16%

Obstetric & Labour-Level Factors

Previous Cesarean

  No

22,624

79%

862

83%

23,486

80%

  Yes

5784

20%

177

17%

5961

20%

  Missing

68

0%

1

0%

69

0%

Obstetrically High Riske

  No

25,784

91%

837

80%

26,621

90%

  Yes

2560

9%

201

19%

2761

9%

  Missing

132

0%

2

0%

134

0%

Referred during labor

  No

21,216

75%

728

70%

21,944

74%

  Yes

7252

25%

311

30%

7563

26%

  Missing

8

0%

1

0%

9

0%

Gestational Age at Birth

  24–33

590

2%

36

3%

626

2%

  34–36

1907

7%

90

9%

1997

7%

  37–42

25,979

91%

914

88%

26,893

91%

Birthweight (grams)

  < 1500

249

1%

26

3%

275

1%

  1500–2500

2427

9%

119

11%

2546

9%

  2500–3500

17,359

61%

587

56%

17,946

61%

  3500–4500

8028

28%

279

27%

8307

28%

  4500+

308

1%

24

2%

332

1%

  Missing

105

0%

5

0%

110

0%

Onset of Labor

  Spontaneous

24,461

86%

881

85%

25,342

86%

  Induced

2957

10%

109

10%

3066

10%

  Missing

1058

4%

50

5%

1108

4%

Parity

  0

15,223

53%

497

2%

15,720

53%

  1+

13,194

46%

529

2%

13,723

46%

  Missing

59

0%

14

0%

73

0%

Fetal Presentation

  Cephalic

24,787

87%

866

83%

25,653

87%

  Breech

2728

10%

122

12%

2850

10%

  Other

904

3%

52

5%

956

3%

  Missing

57

0%

0

0%

57

0%

Number of neonates

  1 neonate

27,520

97%

974

94%

28,494

97%

  ≥ 2 neonates

956

3%

66

6%

1022

3%

Available facility-Level Factors

Obstetrician Performed surgery

  No

11,782

41%

450

43%

12,232

41%

  Yes

16,684

59%

590

57%

17,274

59%

  Missing

10

0%

0

0%

10

0%

Teaching Facility

  No

5058

18%

374

36%

5432

18%

  Yes

23,418

82%

666

64%

24,084

82%

Total Deliveries at Facility

  < 3500

7731

27%

336

32%

8067

27%

  [3500,10,000)

12,148

43%

590

57%

12,738

43%

  10,000+

7431

26%

103

10%

7534

26%

  Missing

1166

4%

11

1%

1177

4%

Urban Facility

  No

25,433

89%

740

71%

26,173

89%

  Yes

2993

11%

294

28%

3287

11%

  Missing

50

0%

6

1%

56

0%

Indication for CS

  Fetal Indication

4997

18%

134

13%

5131

17%

  Failure to Progress/Dystocia

7010

25%

131

13%

7141

24%

  Maternal or Obstetric Indication

1918

7%

127

12%

2045

7%

  Multiples/Malpresentation

2390

8%

88

8%

2478

8%

  Elective

3286

12%

41

4%

3327

11%

  No Other Indication

8832

31%

517

50%

9349

32%

  Missing

43

0%

2

0%

45

0%

  1. a Democratic Republic of Congo, Niger, Nigeria
  2. b Cambodia, India, Nicaragua, Paraguay, Phillipines, Thailand, Vietnam, Algeria, Ecuador, Peru, Sri Lanka, Kenya, Nepal, Uganda, China
  3. c Argentina, Japan, Cuba, Brazil, Mexico
  4. d Medically High Risk Definition: is a dichotomous variable whereby women are considered to be medically high risk if they have chronic hypertension, cardiac or renal disease, pulmonary pathology, diabetes, malaria, sickle cell disease, severe anemia, urinary tract infection, severe condylomatous disease, or HIV or a condition associated with HIV
  5. e Obstetrically High Risk Definition: is a dichotomous variable whereby women are considered obstetrically high risk if they experience hypertension in pregnancy, pre-eclampsia, eclampsia, or have suspected fetal growth impairment
  6. p-values comparing women experiencing adverse outcomes to those who did not, adjusted for country of birth, are shown in the univariate analysis in Table 4