Reproductive Health

Table 2 Risk factors associated with cesarean birth, multivariable models

From: Cesarean birth in the Global Network for Women’s and Children’s Health Research: trends in utilization, risk factors, and subgroups with high cesarean birth rates

	Overall		African sites^b		Non-African sites
	RR (95% CI)^a	p value^a	RR (95% CI)^a	p value^a	RR (95% CI)^a	p value^a
Maternal age (years)		< 0.001		< 0.001		< 0.001
< 20	0.9 (0.9, 0.9)	< 0.001	0.97 (0.96, 0.99)	< 0.001	0.9 (0.9, 0.9)	< 0.001
20–35	Ref		Ref		Ref
> 35	1.1 (1.1, 1.1)	< 0.001	1.0 (1.0, 1.1)	< 0.001	1.1 (1.1, 1.2)	< 0.001
Maternal education		< 0.001		< 0.001		< 0.001
No formal schooling	Ref		Ref		Ref
Primary/secondary	1.3 (1.2, 1.3)	< 0.001	1.0 (1.0, 1.0)	0.04	1.3 (1.2, 1.3)	< 0.001
University+	1.5 (1.4, 1.7)	< 0.001	1.1 (1.1, 1.2)	< 0.001	1.5 (1.4, 1.7)	< 0.001
Parity		< 0.001		0.002		< 0.001
0	1.3 (1.2, 1.4)	< 0.001	1.0 (1.0, 1.1)	< 0.001	1.4 (1.3, 1.5)	< 0.001
1–2	1.2 (1.2, 1.3)	< 0.001	1.0 (1.0, 1.0)	< 0.001	1.3 (1.2, 1.4)	< 0.001
3+	Ref		Ref		Ref
4 + antenatal visits	1.2 (1.2, 1.3)	< 0.001	1.0 (1.0, 1.1)	< 0.001	1.3 (1.2, 1.3)	< 0.001
Multiple pregnancy	1.3 (1.3, 1.4)	< 0.001	1.2 (1.1, 1.3)	< 0.001	1.4 (1.3, 1.4)	< 0.001
OL/PL/FLP	1.1 (1.0, 1.1)	< 0.001	1.1 (1.0, 1.1)	0.01	1.1 (1.1, 1.1)	< 0.001
Antepartum hemorrhage	2.3 (2.0, 2.7)	< 0.001	2.2 (1.7, 2.8)	< 0.001	2.1 (1.9, 2.4)	< 0.001
HTN/PEC/EC	1.6 (1.5, 1.7)	< 0.001	1.2 (1.1, 1.3)	< 0.001	1.5 (1.4, 1.6)	< 0.001

^aRelative risks and p values are obtained from log binomial models as a function of each individual risk factor using generalized estimating equations to account for the correlation of outcomes within cluster
^bOL/PL/FTP represents obstructed labor, prolonged labor, failure to progress
^cHTN/PEC/EC represents hypertension, pre-eclampsia, eclampsia

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