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Trend in primary caesarean delivery: a five-year experience in ABRUZZO, ITALY

Overview of attention for article published in BMC Health Services Research, July 2018
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Title
Trend in primary caesarean delivery: a five-year experience in ABRUZZO, ITALY
Published in
BMC Health Services Research, July 2018
DOI 10.1186/s12913-018-3332-2
Pubmed ID
Authors

Pamela Di Giovanni, Tonia Garzarella, Giuseppe Di Martino, Francesco Saverio Schioppa, Ferdinando Romano, Tommaso Staniscia

Abstract

Primary caesarean section (PCS) rate is one of the main indicators of quality of care suggested by the Italian Government. Hospital rankings are usually based on it, therefore lower rates reflect more appropriate clinical practice. The aim of this study is to describe a five-year trend of PCS rate in Abruzzo region from 2009 to 2013 and to examine the medical indications for this mode of delivery. Forty-five thousand one hundred forty-nine deliveries occurring from 2009 to 2013 were collected from all hospital discharge records (HDR) and analyzed. Among them we found 12,542 PCS. Odds ratios (ORs) with 95% confidence interval (95% CI) were estimated using logistic regression methods to evaluate the relationship between maternal risk factors and PCS in hospital over 1000 delivery/yrs. The five-year PCS rate was 28.9%, with a decreasing trend from 31.4% in 2009 to 26.1% in 2013. Vasto Civil Hospital shows the lowest PCS rate (17.9% in 2013) among hospitals with a maximum of 1000 deliveries per year, while Pescara Civil Hospital shows the lowest PCS rate (25.4% in 2013) among hospitals with over 1000 deliveries per year. Women with major risk factors for cesarean section delivered more frequently in maternity units over 1000 delivery/yrs. Logistic regression analyses showed as diabetes, hypertension, twin pregnancy, fetal distress and preterm delivery were significant risk factors to deliver in unit over 1000 delivery/yrs. The most frequent (overall 66.6%) discharge diagnosis recorded in Hospital discharge records (HDR) is "Caesarean Delivery Without Indication". 7.3% of PCS made in Abruzzo concerns women living in other Italian regions. 11.4% of PCS contains one of the indications to caesarean section (CS) that the Italian Guidelines consider appropriate. During the analyzed period, Abruzzo showed a decreasing, but still too high, PCS rate, compared to the limits fixed by the Italian Ministry of Health. Considering the limitation of this study, based on administrative data that are poor in clinical information, it is not possible to define the appropriateness of all caesarean sections.

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Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 69 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 69 100%

Demographic breakdown

Readers by professional status Count As %
Student > Master 10 14%
Student > Bachelor 10 14%
Student > Postgraduate 7 10%
Other 4 6%
Researcher 4 6%
Other 7 10%
Unknown 27 39%
Readers by discipline Count As %
Medicine and Dentistry 18 26%
Nursing and Health Professions 9 13%
Psychology 6 9%
Agricultural and Biological Sciences 2 3%
Mathematics 1 1%
Other 4 6%
Unknown 29 42%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 2. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 24 July 2018.
All research outputs
#13,622,705
of 23,096,849 outputs
Outputs from BMC Health Services Research
#4,715
of 7,740 outputs
Outputs of similar age
#169,877
of 327,914 outputs
Outputs of similar age from BMC Health Services Research
#167
of 218 outputs
Altmetric has tracked 23,096,849 research outputs across all sources so far. This one is in the 39th percentile – i.e., 39% of other outputs scored the same or lower than it.
So far Altmetric has tracked 7,740 research outputs from this source. They typically receive more attention than average, with a mean Attention Score of 7.8. This one is in the 36th percentile – i.e., 36% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 327,914 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 46th percentile – i.e., 46% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 218 others from the same source and published within six weeks on either side of this one. This one is in the 22nd percentile – i.e., 22% of its contemporaries scored the same or lower than it.