Changing trends in caesarean section births in Murmansk County, Russia

Abstract

Objective: To analyze changing trends of caesarean section (CS) birth rates in Murmansk County, Russia over a 5- year period (2006-2010) using the Robson 10-group classification system. Design: A registry- based study. Setting: The Murmansk County Birth Registry (MCBR). Study population: All deliveries registered (N=44 267) in the MCBR between 1st of January 2006 and 31st of December 2010. Methods: The study population comprises of data from the MCBR and selected perinatal health indicators designed by the Euro-Peristat. The Robson 10- group was applied to categorize all women into 8-modified groups by combining all nulliparous (Groups 1 and 2) and all multiparous (Groups 3 and 4) women with single cephalic pregnancies at ≥ 37 weeks of gestation. The CS rates were examined and described for each group, to identify the most important contributors to CS rates in this population. Results: Maternal age, parity, maternal smoking, education, body mass index, birth weight changed significantly from 2006 to 2010, except gestational age and multiple births. There was an increase in the overall CS proportion from 17.4% to 22.5% in Murmansk County between 2006 and 2010. Nulliparous women (Groups 1 and 2) and women with previous CS (Group 5), with single cephalic pregnancies at ≥ 37 gestational weeks were the greatest contributors at 39% and 31%, respectively, to the overall increase of CS rate from 2006 to 2010. Conclusion: The observed increase in CS rate is mainly attributed to the increase of CS rate in Groups 1 and 2 (first-time CS), followed by Group 5 (repeated CS).