Table 4.
Selected characteristics of the caesarean births performed during the study birth period by group allocation and period
| Factor | Intervention group | Control group | Crude difference in rate change (95% CI) | Intervention effect | ||||||
|---|---|---|---|---|---|---|---|---|---|---|
| Baseline (n = 1060) | Post-intervention (n = 1036) | Diff. | Baseline (n = 1078) | Post-intervention (n = 1000) | Diff. | Adjusted absolute risk difference (95% CI) | Adjusted odds ratio (95% CI) | P value | ||
| Contribution of each group to the overall caesarean section ratea (n, %) | ||||||||||
| Group 1 | 25.47 (270/1060) | 25.09 (260/1036) | − 0.38 | 23.46 (253/1078) | 23.90 (239/1000) | 0.44 | − 4.44 (− 9.60 to 0.75) | − 3.50 (− 5.70 to − 0.60) | 0.66 (0.47 to 0.94) | 0.024 |
| Group 2 | 3.96 (42/1060) | 3.47 (36/1036) | − 0.49 | 4.91 (53/1078) | 2.30 (23/1000) | − 2.61 | 1.52 (− 0.73 to 3.77) | 1.00 (− 0.40 to 3.40) | 1.45 (0.82 to 2.56) | 0.189 |
| Group 3 | 24.24 (257/1060) | 23.74 (246/1036) | − 0.50 | 24.11 (260/1078) | 29.00 (290/1000) | 4.89 | − 6.56 (− 11.81 to − 1.31) | − 6.80 (− 11.5 to − 1.00) | 0.70 (0.52 to 0.95) | 0.022 |
| Group 4 | 4.24 (45/1060) | 3.47 (36/1036) | − 0.70 | 6.02 (65/1078) | 4.40 (44/1000) | − 1.62 | 0.05 (− 2.45 to 2.56) | −0.10 (− 1.90 to 3.10) | 0.98 (0.55 to 1.76) | 0.969 |
| Group 5 | 18.67 (198/1060) | 18.24 (189/1036) | − 0.43 | 17.53 (189/1078) | 16.40 (164/1000) | − 1.13 | − 1.91 (− 6.53 to 2.70) | − 6.00 (− 6.00 to 6.90) | 0.96 (0.59 to 1.55) | 0.888 |
| Group 6 | 1.79 (19/1060) | 2.99 (31/1036) | 1.20 | 2.41 (26/1078) | 2.20 (22/1000) | − 0.21 | 0.96 (− 0.85 to 2.78) | 1.20 (− 0.60 to 4.70) | 1.57 (0.74 to 3.31) | 0.236 |
| Group 7 | 2.64 (28/1060) | 4.72 (49/1036) | 2.08 | 2.87 (31/1078) | 2.90 (29/1000) | 0.03 | 1.34 (− 0.80 to 3.49) | 1.6 (− 0.30 to 4.90) | 1.59 (0.89 to 2.85) | 0.116 |
| Group 8 | 6.13 (65/1060) | 3.66 (38/1036) | − 2.47 | 5.93 (64/1078) | 4.60 (46/1000) | − 1.33 | − 2.06 (− 4.70 to 0.57) | − 1.70 (− 2.70 to 0.00) | 0.63 (0.40 to 1.00) | 0.051 |
| Group 9 | 4.15 (44/1060) | 5.88 (61/1036) | 1.73 | 2.87 (31/1078) | 4.50 (45/1000) | 1.63 | − 0.66 (− 3.13 to 1.80) | − 1.60 (− 2.80 to 1.30) | 0.63 (0.36 to 1.30) | 0.256 |
| Group 10 | 8.67 (92/1060) | 8.68 (90/1036) | 0.01 | 9.83 (106/1078) | 9.80 (98/1000) | − 0.03 | − 1.35 (− 4.85 to 2.14) | − 1.00 (− 4.10 to 3.40) | 0.89 (0.56 to 1.40) | 0.619 |
| Caesarean performed before labour (vs during labour) | 17.07 (181/1060) | 15.34 (159/1036) | − 1.73 | 16.04 (173/1078) | 16.60 (166/1000) | 0.56 | − 1.16 (− 13.02 to 10.70) | − 1.14 (− 10.60 to 16.80) | 0.90 (0.32 to 2.52) | 0.846 |
| Caesarean by indication (n, %) | ||||||||||
| Foetal distress | 32.26 (342/1060) | 20.75 (275/1036) | − 11.41 | 30.42 (328/1078) | 23.00 (230/1000) | − 7.42 | − 0.41 (− 5.69 to 4.87) | −2.40 (−8.50 to 5.30) | 0.87 (0.57 to 1.32) | 0.518 |
| Labour dystocia | 23.77 (252/1060) | 40.54 (420/1036) | 16.77 | 23.74 (256/1078) | 35.30 (353/1000) | 11.56 | 4.59 (− 1.34 to 10.53) | 4.10 (−4.90 to 13.80) | 1.19 (0.80 to 1.77) | 0.379 |
| Previous caesarean | 17.64 (187/1060) | 14.18 (147/1036) | − 3.46 | 17.71 (191/1078) | 15.50 (155/1000) | − 2.21 | − 7.36 (− 11.79 to − 2.93) | −5.00 (− 100.10 to 3.90) | 0.64 (0.31 to 1.31) | 0.227 |
| Pre-eclampsia/eclampsia | 6.69 (71/1060) | 2.99 (31/1036) | − 3.70 | 5.75 (62/1078) | 5.00 (50/1000) | − 0.75 | − 1.35 (− 3.96 to 1.25) | −1.80 (− 3.20 to 0.80) | 0.63 (0.34 to 1.16) | 0.143 |
| Other indication | 5.37 (57/1060) | 8.30 (86/1036) | 2.93 | 6.21 (67/1078) | 8.10 (81/1000) | 1.89 | 1.60 (− 3.40 to 6.62) | 0.70 (− 2.00 to 4.50) | 1.10 (0.74 to 1.63) | 0.617 |
| Case fatality (n, %) | ||||||||||
| Maternal death | 0.75 (8/1060) | 0.19 (2/1036) | − 0.56 | 0.92 (10/1078) | 0.40 (4/1000) | − 0.52 | − 0.02 (− 0.91 to 0.87) | − 0.30 (− 0.40 to 0.50) | 0.32 (0.04 to 2.23) | 0.253 |
| Intrapartum-related neonatal death | 4.95 (53/1069) | 6.32 (64/1012) | 1.37 | 5.80 (63/1085) | 4.29 (43/1002) | − 1.51 | 2.78 (− 0.18 to 5.76) | 2.90 (− 0.70 to 9.80) | 1.73 (0.82 to 3.66) | 0.149 |
Data are the numbers of caesareans per 100 patients (percentages of unnecessary caesarean section) by group allocation and period
aThe Robson ten-group classification system [3]