Table 3. Factors associated with cesarean section without labor by type of financing of labor, Brazil, 2011–2012.
| Variables | Public healthcare | Private healthcare | ||||
|---|---|---|---|---|---|---|
| OR (95%CI) | Model 1a AOR (95%CI) | Model 2b AOR (95%CI) | OR (95%CI) | Model 1a AOR (95%CI) | Model 2b AOR (95%CI) | |
| Maternal characteristics | ||||||
| Maternal age | ||||||
| 20–29 years old | 1.00 (ref.) | 1.00 (ref.) | 1.00 (ref.) | 1.00 (ref.) | 1.00 (ref.) | 1.00 (ref.) |
| ≥ 35 years old | 1.50 (1.32–1.70) | 1.63 (1.37–1.93) | 1.63 (1.38–1.94) | 1.71 (1.34–2.17) | 1.50 (1.19–1.89) | 1.44 (1.13–1.83) |
| Maternal schooling | ||||||
| ≤ 7 years | 1.00 (ref.) | 1.00 (ref.) | 1.00 (ref.) | 1.00 (ref.) | 1.00 (ref.) | - |
| 8–10 years | 1.19 (1.02–1.39) | 1.20 (0.99–1.44) | 1.20 (0.99–1.45) | 1.76 (1.01–3.09) | 1.62 (0.90–2.90) | - |
| ≥ 11 years | 1.61 (1.37–1.90) | 1.37 (1.12–1.67) | 1.38 (1.13–1.68) | 2.37 (1.26–4.43) | 1.27 (0.72–2.23) | - |
| Skin color | ||||||
| White | 1.00 (ref.) | 1.00 (ref.) | - | 1.00 (ref.) | 1.00 (ref.) | - |
| non-white | 1.29 (1.11–1.49) | 1.06 (0.92–1.22) | - | 1.28 (1.05–1.56) | 0.83 (0.62–1.20) | - |
| Prenatal and childbirth characteristics | ||||||
| Same doctor PN and childbirth | ||||||
| No | 1.00 (ref.) | 1.00 (ref.) | 1.00 (ref.) | 1.00 (ref.) | 1.00 (ref.) | 1.00 (ref.) |
| Yes | 4.90 (3.95–6.08) | 4.55 (3.69–5.62) | 4.57 (3.71–5.63) | 5.26 (3.44–8.06) | 4.14 (2.61–6.57) | 4.18 (2.66–6.59) |
| Adequacy PN | ||||||
| Inadequate | 1.00 (ref.) | 1.00 (ref.) | 1.00 (ref.) | - | - | - |
| Adequate | 1.34 (1.16–1.56) | 1.26 (1.06–1.49) | 1.26 (1.07–1.49) | - | - | - |
| Search for healthcare unit for childbirth | ||||||
| Yes | 1.00 (ref.) | 1.00 (ref.) | 1.00 (ref.) | 1.00 (ref.) | 1.00 (ref.) | - |
| No | 1.48 (1.25–1.74) | 1.31 (1.11–1.55) | 1.32 (1.11–1.56) | 2.12 (1.35–3.32) | 1.34 (0.82–2.17) | - |
| Summary measure of obstetric risk | ||||||
| Low | 1.00 (ref.) | 1.00 (ref.) | 1.00 (ref.) | 1.00 (ref.) | 1.00 (ref.) | 1.00 (ref.) |
| High | 1.87 (1.67–2.09) | 2.08 (1.82–2.37) | 2.08 (1.82–2.37) | 1.50 (1.22–1.83) | 1.62 (1.22–2.13) | 1.59 (1.21–2.08) |
| Initial preference for the type of childbirth | ||||||
| Vaginal / no preference | 1.00 (ref.) | 1.00 (ref.) | 1.00 (ref.) | 1.00 (ref.) | 1.00 (ref.) | 1.00 (ref.) |
| Cesarean | 2.90 (2.54–3.30) | 1.56 (1.33–1.83) | 1.57 (1.34–1.84) | 6.03 (4.52–8.05) | 3.84 (2.80–5.27) | 3.84 (2.79–5.29) |
| Parity | ||||||
| Multipara without previous CS | 1.00 (ref.) | 1.00 (ref.) | 1.00 (ref.) | 1.00 (ref.) | 1.00 (ref.) | 1.00 (ref.) |
| Nulliparous | 3.95 (3.45–4.51) | 4.03 (3.41–4.77) | 4.03 (3.41–4.77) | 6.24 (4.44–8.77) | 6.24 (4.24–9.19) | 5.94 (4.15–8.51) |
| Multipara with previous CS = 1 | 10.53 (8.61–12.89) | 9.78 (7.88–12.14) | 9.79 (7.89–12.15) | 22.96 (15.78–33.42) | 12.92 (9.03–18.47) | 12.41 (8.73–17.64) |
| Multipara with previous CS ≥ 2 | 47.59 (32.56–69.55) | 46.50 (30.7–70.4) | 46.55 (30.8–70.4) | 30.54 (9.39–99.39) | 11.69 (3.38–40.37) | 11.34 (3.42–37.63) |
CS: cesarean section; PN: prenatal care; ref.: reference.
a Model adjusted for all variables included in the gross analysis.
b Model adjusted only by the variables that remained in the final model.
Interaction was tested by the same doctor during the PN and childbirth*initial preference through childbirth; adequacy of the PN*same professional during the PN and childbirth; age*schooling; education*skin color; adequacy of the obstetric PN*obstetric risk.