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. 2019 Feb 8;9(2):e027317. doi: 10.1136/bmjopen-2018-027317

Table 3.

Assessment of the type of population

Steps for interpretation Interpretation by Robson Example: MCS population Our findings Additional information from the database used to interpret data Final interpretation
STEP 1. Size of group 1+group 2 35%–42% 38.1% 38.1% Rate in line with both references by Robson and the MCS reference population.
STEP 2. Size of groups 3+4 30% 46.5% 37.3% Multiparous in our population 55.0% Rate higher than Robson references but lower than MCS examples. This may be explained by a high prevalence of multiparous women in our population.
STEP 3. Size of group 5 Half of total CS rate 7.2% 10.9% Lower than half of total CS. This, as suggested by the WHO manual, may be due to relatively low CS rate in the previous years, or to a recently increased CS rate or to misclassification.
STEP 4. Size of groups 6+7 3%–4% 2.7% 3.4% Rate in line with both Robson references and MCS examples.
STEP 5. Size of group 8 1.5%–2% 0.9% 1.1% Rate in line with MCS examples.
STEP 6. Size of group 10 <5% 4.2% 7.8% Divisions by gestational age in our preterm population Higher than both comparisons. This may be explained by the hospital being a tertiary care referral centre, or by misclassification.
STEP 7. Ratio of the size of group one versus group 2 Ratio 2 or higher Ratio 3.3 Ratio 1.5 Indication of IOL Lower than the comparisons. This associates with a large size of group 2a, suggesting a high incidence of IOL. This may be explained by: (1) Case selection (tertiary care referral centre). (2) Inappropriate indication to IOL (deserving further investigation).
STEP 8. Ratio of size of group 3 versus group 4 > 2:1 Ratio 6.3 Ratio 2.6 Indication of IOL Rate in line with both Robson references, lower than MCS. This may be explained by: (1) Misclassification of augmentation as IOL. (2) Case selection (tertiary care referral centre). (3) Inappropriate indication to IOL (deserving further investigation).
STEP 9. Ratio of size of group 6 versus group 7 Usually 2:1 Ratio 0.8 Ratio 1.2 Multiparous in our population 55.0% Rate in line with MCS, but lower than Robson references. This may be explained by: (1) High number of multiparous women in our population.

CS, caesarean section; IOL, induction of labour; MCS, Multicountry Survey; MCS reference population: was the population of the WHO MCS with relatively low CS rates and, at the same time, with good outcomes of labour and childbirth.