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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
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