Article
Analysing caesarean section rates using Robson Ten Classification
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Authors
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Marie Strohauer
- Institute of Midwifery Science of the Charité, University Medicine Berlin, Germany
| Published: | February 7, 2024 |
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Outline
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Background: Caesarean section (CS) rates have been rising globally and are on average 30% in Germany since 2019. WHO recommends a CS rate under 19% which means responsible and evidence-guided reduction of the CS rate is necessary to reduce morbidity and mortality of women and children. For a target group-specific reduction more valid data is needed. WHO and EURO-Peristat recommends Robson Ten Classification for systematic CS data analysis at international-, national-, and hospital level. This research applied Robson Ten Classification to Charité data.
Methods: Modified Robson Ten Classification was used to analyse all births at Charité – Universitätsmedizin Berlin from 2019–2021. Classification of all 16,289 deliveries was carried out using SPSS. Data was split between Charité’s two obstetric departments and descriptive analysis including group distribution, CS rate within Robson groups, relative share of the overall CS rate, prevalence of age >35 years and diabetes mellitus type I & II. Binary logistic regression was used to identify correlations between CS and selected certain Robson groups.
Results: Most of the CS occurred in the groups with high obstetric risk. This includes e.g. breech presentation (n=879, 5%), malpresentation of the fetus (n=246, 2%) and previous CS (n=2,360, 14%). All of those show a significant positive correlation with CS (p<0.001). Furthermore the Robson Ten Classification revealed disparities between the two hospital sites concerning the groups of women more likely to undergo a Caesarean section, despite similar risk distribution. Despite the inherent weaknesses of the Robson Ten Classification, it appears to be a suitable tool for systematic consideration of the CS collective.
Ethics and conflicts of interest: This abstract was written in the context of a master’s thesis. A vote on ethics was not necessary. The research was financed by own resources. There are no conflicts of interest.
The PDF file of the poster submitted for the meeting is available in German as Attachment 1 [Attach. 1].
