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Trends in the Mode of Delivery of Pregnant Women in Rural Guatemala from a Quality Improvement Database.
- Source :
-
Maternal & Child Health Journal . Apr2019, Vol. 23 Issue 4, p435-442. 8p. 1 Diagram, 4 Charts, 2 Graphs. - Publication Year :
- 2019
-
Abstract
- Purpose To evaluate trends and factors associated with mode of delivery in the rural Southwest Trifinio region of Guatemala. Description We conducted a retrospective analysis of self-reported antepartum factors and postpartum outcomes recorded in a quality improvement database among 430 women enrolled in a home-based maternal healthcare program between June 1, 2015 and August 1, 2017. Assessment Over the study period, the rates of cesarean delivery (CD) increased (from 30 to 45%) and rates of vaginal delivery (VD) decreased (70–55%) while facility-based delivery attendance remained stable around 70%. Younger age (23.5 years for VD vs. 21.6 years for CD, p < 0.001), nulliparity (25.1% for VD vs. 45.0% for CD, p < 0.001), prolonged/obstructed labor (2.4% for VD vs. 55.6% for CD, p < 0.001), and fetal malpresentation (0% for VD vs. 16.3% CD, p < 0.001) significantly influenced mode of delivery in univariate analysis. The leading indications for CD were labor dysfunction (47.5%), malpresentation (14.5%), and prior cesarean delivery (19.8%). The CD rate among the subpopulation of term, nulliparous women with singleton pregnancies in vertex presentation also increased from 20% of all CD in 2015, to 38% in 2017. Conclusion Among low-income women from rural Guatemala, the CD rate has increased above the World Health Organization (WHO) recommendations in a period of 3 years. Additional research on the factors affecting this trend are essential to guide interventions that might improve the appropriateness of CD, and to determine if reducing or stabilizing rates is necessary. [ABSTRACT FROM AUTHOR]
- Subjects :
- *CESAREAN section
*CHI-squared test
*DELIVERY (Obstetrics)
*FETAL presentation
*FISHER exact test
*MATERNAL age
*MATERNAL health services
*PREGNANCY & psychology
*REGRESSION analysis
*RESEARCH funding
*RURAL conditions
*SELF-evaluation
*STATISTICS
*T-test (Statistics)
*VAGINA
*RETROSPECTIVE studies
*PARITY (Obstetrics)
*DATA analysis software
*DESCRIPTIVE statistics
*MANN Whitney U Test
Subjects
Details
- Language :
- English
- ISSN :
- 10927875
- Volume :
- 23
- Issue :
- 4
- Database :
- Academic Search Index
- Journal :
- Maternal & Child Health Journal
- Publication Type :
- Academic Journal
- Accession number :
- 135608019
- Full Text :
- https://doi.org/10.1007/s10995-018-2655-2