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Epidemiology Analysis of Caesarean Section in Central, Eastern and Southeastern European Countries

Chellai, Fatih (2023): Epidemiology Analysis of Caesarean Section in Central, Eastern and Southeastern European Countries.

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The increase in caesarean section (CS) rates across countries has caused several health, social, and economic problems. The objectives are to estimate the prevalence and trend of caesarian sections and to investigate the determinants of such a dynamic. Secondary data from multiple indicator cluster surveys (MICS) were used for a set of countries in Central, Eastern, and Southeastern Europe. A meta-analysis was performed and multivariable logistic models were fitted. The findings showed high heterogeneity of CS rates among the study countries, with rates ranging from 11.1% in Ukraine to 40.4% in the Republic of Macedonia. In terms of the dynamics of C-section use over time, the results showed, within countries, that the rates are increasing sharply for all women. The inequalities between subgroups in these countries have been revealed, notably by area and region. Except for mother’s age and baby size at birth (for specific countries), univariate and multivariate logistic regression revealed that none of the determinants were significantly associated (p>0.05) with the use of C-section. The results show that inequalities in the C-section exist within and between countries. However, considering the rationale for the use of caesarean sections, we need to implement different and flexible approaches with respect to the characteristics of each country in terms of demography, health systems, and economic levels.

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