Risk of neonatal hospitalization associated to delivery by cesarean section in a high complexity clinic in Bogotá, Colombia, 2018
DOI:
https://doi.org/10.18597/rcog.3364Keywords:
cesárea, parto obstétrico, parto vaginal después de cesárea, cesárea repetida, clasificación, inicio del trabajo de parto.Abstract
Objective: To evaluate the association between cesarean delivery and hospitalization of the newborn and describe the indications for cesarean according to Robson’s groups in the obstetrics service of a highly complex general institution. Materials and methods: Cross-sectional study. All births occurred between March and July 2018 in a high complexity general teaching hospital in Bogotá, Colombia were included, by consecutive sampling up to a sample size of 1040 pregnant women. The frequency of caesarean section, indications, neonatal outcomes for each Robson group, and the risk of neonatal hospitalization are described using the crude and adjusted odds ratio (OR) using multivariate analysis. Results: 1,493 births were included, of which 539 (36.3 %) were by cesarean section. Women with a history of uterine scar scheduled for elective caesarean section and those hospitalized for induction provide the majority of caesarean sections. The main indications for cesarean section were suspicion of unsatisfactory fetal status and prolongued labor. Adjusted for birth weight, caesarean section increased the overall risk of neonatal hospitalization (adjusted OR [aOR] = 2,2; IC 99 %: 1,3-3,7). Conclusions: There are groups of Robson susceptible of intervention to decrease the rate of caesarean sections due to the suspicion of unsatisfactory fetal status and prolongation of labor. An association was found between cesarean delivery and subsequent neonatal hospitalization. Randomized controlled studies are required to determine the benefit of the strategies to reduce cesarean section rates and evaluate the association found.
Author Biographies
Nathalia Mora-Soto, Universidad Nacional de Colombia
Médico cirujano. Especialista en Obstetricia y Ginecología, Universidad Nacional de Colombia. Bogotá, Colombia.
Luis Alejandro Villegas-Agudelo, Universidad Nacional de Colombia
Médico cirujano. Especialista en Obstetricia y Ginecología, Universidad Nacional de Colombia. Bogotá, Colombia.
Lissette Alejandra López-Moreno, Universidad Nacional de Colombia
Médico cirujano. Especialista en Obstetricia y Ginecología, Universidad Nacional de Colombia. Bogotá, Colombia.
Carlos Alberto Ramírez-Serrano, Clínica Juan N. Corpas
Médico cirujano. Especialista en Obstetricia y Ginecología. Jefe médico del servicio de Ginecobstetricia, Clínica Juan N. Corpas. Bogotá, Colombia.
Jorge Andrés Rubio-Romero, Universidad Nacional de Colombia
Médico cirujano. Especialista en Obstetricia y Ginecología. Profesor titular, Departamento de Obstetricia y Ginecología, Universidad Nacional de Colombia. Bogotá, Colombia.
References
Organización Mundial de la Salud. Declaración de la OMS sobre tasa de cesárea. Hum Reprod Program. 2015;8. Disponible en:
https://doi.org/10.1016/j.rhm.2015.07.007
Betrán AP, Ye J, Moller AB, Zhang J, Gülmezoglu AM, Torloni MR. The increasing trend in caesarean section rates: Global, regional and national estimates: 1990-2014. PLoS One. 2016;11(2):1-12.
https://doi.org/10.1371/journal.pone.0148343
Rubio-Romero JA, Fonseca-Pérez JE, Molina S, Buitrago-Leal M, Zuleta JJ, Ángel-Müller E. Racionalización del uso de la cesárea en Colombia. Consenso de la Federación Colombiana de Obstetricia y Ginecología (Fecolsog) y la Federación Colombiana de Perinatología (Fecopen). Bogotá, 2014. Rev Colomb Obs Ginecol. 2014;65(2):139-51.
https://doi.org/10.18597/rcog.61
Souza JP, Gülmezoglu A, Lumbiganon P, Laopaiboon M, Carroli G, Fawole B, et al. Caesarean section without medical indications is associated with an increased risk of adverse short-term maternal outcomes: The 2004-2008 WHO Global Survey on Maternal and Perinatal Health. BMC Med. 2010;8:71.
https://doi.org/10.1186/1741-7015-8-71
Villar J, Carroli G, Zavaleta N, Donner A, Wojdyla D, Faundes A, et al. Maternal and neonatal individual risks and benefits associated with caesarean delivery: multicentre prospective study. BMJ. 2007;335(7628):1025.
https://doi.org/10.1136/bmj.39363.706956.55
Aguilar AJ. Cesárea electiva: repercusión en la evolución respiratoria neonatal. Ginecol Obstet Mex. 2011;79(04):206-13.
Robson MS. Can we reduce the caesarean section rate? Best Pract Res Clin Obstet Gynaecol. 2001 Feb;15(1):179-94.
https://doi.org/10.1053/beog.2000.0156
Tanaka K, Mahomed K. The Ten-Group Robson Classification: A single centre approach identifying strategies to optimise caesarean section rates. Obstet Gynecol Int. 2017;2017:1-5.
https://doi.org/10.1155/2017/5648938
Zuleta-Tobón JJ, Quintero-Rincón F, Quiceno-Ceballos AM. Aplicación del modelo de Robson para caracterizar la realización de cesáreas en una institución de tercer nivel de atención en Medellín, Colombia: estudio de corte transversal. Rev Colomb Obstet Ginecol. 2013;64(2):90-9.
https://doi.org/10.18597/rcog.115
Jiménez-Hernández DL, Guevara-Rodríguez A del P, Zuleta-Tobón JJ, Rubio-Romero JA. Tasa de cesáreas por grupos de Robson en una institución de mediana complejidad de la ciudad de Bogotá, 2012-2014. Rev Colomb Obstet Ginecol. 2016;67(2):101-11.
https://doi.org/10.18597/rcog.381
Hulley SB, Cummings SR, Browner WS, Grady DG, Newman TB. Designing Clinical Research. 3rd ed. Philadelphia: Lippincott Williams & Wilkins, 2011; 2011. 384 p.
DANE. Salud/Nacimientos y defunciones/Nacimientos 2017. Estadísticas demográficas Colombia. 2018. Disponible en: https://www.dane.gov.co/index.php/estadisticas-por-tema/salud/nacimientos-y-defunciones/nacimientos/nacimientos-2017
Aguilar Redondo R, Manrique Fuentes G, Aisa Denaroso LM, Delgado Martínez L, González Acosta V, Aceituno Velasco L. Uso de la clasificación de Robson en un hospital comarcal de España para reducir la tasa de cesáreas. Rev Chil Obstet Ginecol. 2016;81(2):99-104.
https://doi.org/10.4067/S0717-75262016000200003
Vengoechea PJC, Pérez AC, Betrán AP, Morey M del MM, Borges MMF, Alcácer PX, et al. Clasificación de cesáreas por Grupos de Robson en dos periodos comparativos en el Hospital de Manacor. Progresos Obstet y Ginecol. 2010;53(10):385-90.
https://doi.org/10.1016/j.pog.2010.05.003
Guise J-M, Eden K, Emeis C, Denman MA, Marshall N, Fu RR, et al. Vaginal birth after cesarean: new insights. Evid Rep Technol Assess (Full Rep). 2010 Mar;(191):1-397.
Sánchez Pacheco NR. Caracterización de las cesáreas por modelo Robson en la Clínica de Maternidad Rafael Calvo de Cartagena. 34 p. Disponible en: http://hdl.handle.net/11227/5921
Hofmeyr GJ, Hannah M, Lawrie TA. Planned caesarean section for term breech delivery. Cochrane Database Syst Rev. 2015 Jul;2015(7).
https://doi.org/10.1002/14651858.CD000166.pub2
Cunningham F, Leveno K, Bloom S, Dashe J, Hoffman B. Williams Obstetrics. 25th ed. New York: McGraw-Hill Medical; 2018.
Álvarez-Zapata EA, González-Hernández LM, Jiménez-Arango NB, Zuleta-Tobón JJ. Cumplimiento inadecuado de las recomendaciones para el proceso de la inducción del trabajo de parto como desencadenante de la cesárea en mujeres con embarazo simple a término. Estudio descriptivo. Rev Colomb Obstet Ginecol. 2019 Jul;70(2):103-14.
https://doi.org/10.18597/rcog.3275
Vrouenraets FPJM, Roumen FJME, Dehing CJG, van den Akker ESA, Aarts MJB, Scheve EJT. Bishop score and risk of cesarean delivery after induction of labor in nulliparous women. Obstet Gynecol. 2005 Apr;105(4):690-7.
https://doi.org/10.1097/01.AOG.0000152338.76759.38
Brennan DJ, Robson MS, Murphy M, O’Herlihy C. Comparative analysis of international cesarean delivery rates using 10-group classification identifies significant variation in spontaneous labor. Am J Obstet Gynecol. 2009;201(3):308.e1-308.e8.
https://doi.org/10.1016/j.ajog.2009.06.021
WHO recommendations for induction of labour. 2011. Disponible en: https://www.who.int/reproductivehealth/publications/maternal_perinatal_health/9789241501156/en/
McCarthy FP, Rigg L, Cady L, Cullinane F. A new way of looking at Caesarean section births. Aust N Z J Obstet Gynaecol. 2007;47(4):316-20.
https://doi.org/10.1111/j.1479-828X.2007.00753.x
Lenus, The Irish Health Repository. National Maternity Hospital, Holles Street, annual report 1998. 1999. Disponible en: http://hdl.handle.net/10147/249956
Silva LPM, León MGM, Rodríguez JMB. Unidad de Cuidados Intensivos Neonatales: Morbimortalidad en recién nacidos prematuros. Acta Univ. 2007;17(1):46-51.
https://doi.org/10.15174/au.2007.167
Mendoza Tascón LA, Gómez Giraldo D, Gómez Giraldo D, Osorio Ruiz MA, Villamarín Betancourth EA, Arias Guatibonza MD, et al. Determinantes biológicos de mortalidad neonatal, en una población de mujeres adolescentes y adultas de un hospital en Colombia. Rev Chil Obstet Ginecol. 2017;82(4):424-37.
https://doi.org/10.4067/s0717-75262017000400424
Alonso Uría RM, Lugo Sánchez AM, Álvarez Ponce V, Rodríguez Alonso B, Vasallo Pastor N, Remy Pérez M, et al. Mortalidad neonatal precoz: análisis de 15 años. Rev Cuba Obs ginecol. 2005;31(3):0-0.
Saccone G, Berghella V. Antenatal corticosteroids for maturity of term or near term fetuses: Systematic review and meta-analysis of randomized controlled trials. BMJ. 2016;355:1-10.
https://doi.org/10.1136/bmj.i5044
Sotiriadis A, Makrydimas G, Papatheodorou S, Ioannidis JPA, McGoldrick E. Corticosteroids for preventing neonatal respiratory morbidity after elective caesarean section at term. Cochrane Database Syst Rev. 2018;(8).
How to Cite
Downloads
Downloads
Published
Issue
Section
| Article metrics | |
|---|---|
| Abstract views | |
| Galley vies | |
| PDF Views | |
| HTML views | |
| Other views | |
