Robson 10-groups classification system to access C-section in two public hospitals of the Federal District/Brazil

PLoS One. 2018 Feb 20;13(2):e0192997. doi: 10.1371/journal.pone.0192997. eCollection 2018.

Abstract

Background: The global increase in C-section rates is real. In Brazil, these indices correspond to 58.94% in the Midwest region and 52.77% in the Federal District.

Objective: To evaluate the C-section rates and identify the groups with the greatest risk at two reference hospitals in the public network of Federal District/Brazil, using 10-Group Robson System.

Method: A cross-sectional study of 6579 births assisted at the Hospital A (HA) and the Hospital B (HB) during 2013. The C-section rates in each group and its respective contribution to the total hospital C-sections was compared between HA and HB. To this, was used the proportion difference test (similar to chi-square test), with RR and 95% CI, and the logistic regression analysis (OR; 95% CI) among the groups with higher C-section/total C-section. The significance limit of p < 0.05 was defined for all tests.

Results: The C-section rates were 50.8% at the HA and 42.3% at the HB, with 1.20 RR (95%CI = 1.13-1.28) at the HA. The highest rates were observed in Robson groups G5, G1, and G2. At the HA, G1 had a 21.5% C-section rate, which was greater than at the HB (13.8%; p < 0.05); the cesarean rates for groups G2 and G5 were higher at the HB (respectively, 18.6 and 38.1%) than at the HA (14.8 and 32.5%, respectively; p < 0.05).

Conclusion: These results point out specific goals to be achieved in order to reduce abusive cesarean rates in both A and B hospitals, especially in the primigravida and in those with previous C-section.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Brazil
  • Cesarean Section / statistics & numerical data*
  • Cross-Sectional Studies
  • Electronic Health Records
  • Female
  • Hospitals, Public / statistics & numerical data*
  • Humans
  • Logistic Models
  • Parity
  • Prospective Studies
  • Risk Assessment
  • Unnecessary Procedures
  • Young Adult

Grants and funding

This study is part of a larger research project funded by Escola Superior de Ciências da Saúde (ESCS), supported by Fundação de Ensino e Pesquisa em Ciências da Saúde da Secretaria de Estado de Saúde do Distrito Federal (FEPECS/ SES-DF).