TY - JOUR
T1 - Trends in caesarean section rates in Europe from 2015 to 2019 using Robson's Ten Group Classification System
T2 - A Euro-Peristat study
AU - Amyx, Melissa
AU - Philibert, Marianne
AU - Farr, Alex
AU - Donati, Serena
AU - Smárason, Alexander K
AU - Tica, Vlad
AU - Velebil, Petr
AU - Alexander, Sophie
AU - Durox, Mélanie
AU - Elorriaga, Maria Fernandez
AU - Heller, Günther
AU - Kyprianou, Theopisti
AU - Mierzejewska, Ewa
AU - Verdenik, Ivan
AU - Zīle-Velika, Irisa
AU - Zeitlin, Jennifer
AU - Euro-Peristat Research Group
AU - Billy, Audrey
AU - Lecomte, Aline
AU - Pastore, Jessica
AU - Weber, Guy
N1 - Funding information
This research was part of PHIRI (Population Health Information Research Infrastructure), which received funding from the European Union's Horizon 2020 Research and Innovation programme (grant agreement No 101018317). The funding source was not involved in conducting this research or writing this manuscript.
© 2023 The Authors. BJOG: An International Journal of Obstetrics and Gynaecology published by John Wiley & Sons Ltd.
PY - 2024/3
Y1 - 2024/3
N2 - OBJECTIVE: To assess changes in caesarean section (CS) rates in Europe from 2015 to 2019 and utilise the Robson Ten Group Classification System (TGCS) to evaluate the contribution of different obstetric populations to overall CS rates and trends.DESIGN: Observational study utilising routine birth registry data.SETTING: A total of 28 European countries.POPULATION: Births at ≥22 weeks of gestation in 2015 and 2019.METHODS: Using a federated model, individual-level data from routine sources in each country were formatted to a common data model and transformed into anonymised, aggregated data.MAIN OUTCOME MEASURES: By country: overall CS rate. For TGCS groups (by country): CS rate, relative size, relative and absolute contribution to overall CS rate.RESULTS: Among the 28 European countries, both the CS rates (2015, 16.0%-55.9%; 2019, 16.0%-52.2%) and the trends varied (from -3.7% to +4.7%, with decreased rates in nine countries, maintained rates in seven countries (≤ ± 0.2) and with increasing rates in 12 countries). Using the TGCS (for 17 countries), in most countries labour induction increased (groups 2a and 4a), whereas multiple pregnancies (group 8) decreased. In countries with decreasing overall CS rates, CS tended to decrease across all TGCS groups, whereas in countries with increasing rates, CS tended to increase in most groups. In countries with the greatest increase in CS rates (>1%), the absolute contributions of groups 1 (nulliparous term cephalic singletons, spontaneous labour), 2a and 4a (induction of labour), 2b and 4b (prelabour CS) and 10 (preterm cephalic singletons) to the overall CS rate tended to increase.CONCLUSIONS: The TGCS shows varying CS trends and rates among countries of Europe. Comparisons between European countries, particularly those with differing trends, could provide insight into strategies to reduce CS without clinical indication.
AB - OBJECTIVE: To assess changes in caesarean section (CS) rates in Europe from 2015 to 2019 and utilise the Robson Ten Group Classification System (TGCS) to evaluate the contribution of different obstetric populations to overall CS rates and trends.DESIGN: Observational study utilising routine birth registry data.SETTING: A total of 28 European countries.POPULATION: Births at ≥22 weeks of gestation in 2015 and 2019.METHODS: Using a federated model, individual-level data from routine sources in each country were formatted to a common data model and transformed into anonymised, aggregated data.MAIN OUTCOME MEASURES: By country: overall CS rate. For TGCS groups (by country): CS rate, relative size, relative and absolute contribution to overall CS rate.RESULTS: Among the 28 European countries, both the CS rates (2015, 16.0%-55.9%; 2019, 16.0%-52.2%) and the trends varied (from -3.7% to +4.7%, with decreased rates in nine countries, maintained rates in seven countries (≤ ± 0.2) and with increasing rates in 12 countries). Using the TGCS (for 17 countries), in most countries labour induction increased (groups 2a and 4a), whereas multiple pregnancies (group 8) decreased. In countries with decreasing overall CS rates, CS tended to decrease across all TGCS groups, whereas in countries with increasing rates, CS tended to increase in most groups. In countries with the greatest increase in CS rates (>1%), the absolute contributions of groups 1 (nulliparous term cephalic singletons, spontaneous labour), 2a and 4a (induction of labour), 2b and 4b (prelabour CS) and 10 (preterm cephalic singletons) to the overall CS rate tended to increase.CONCLUSIONS: The TGCS shows varying CS trends and rates among countries of Europe. Comparisons between European countries, particularly those with differing trends, could provide insight into strategies to reduce CS without clinical indication.
UR - https://pubmed.ncbi.nlm.nih.gov/37779035
U2 - 10.1111/1471-0528.17670
DO - 10.1111/1471-0528.17670
M3 - Article
C2 - 37779035
SN - 1470-0328
VL - 131
SP - 444
EP - 454
JO - BJOG: An International Journal of Obstetrics and Gynaecology
JF - BJOG: An International Journal of Obstetrics and Gynaecology
IS - 4
ER -