Please use this identifier to cite or link to this item: https://doi.org/10.1111/birt.12341
Title: Trends and predictors of cesarean birth in Singapore, 2005-2014: A population-based cohort study
Authors: Chi, Claudia 
Pang, Deanette
Aris, Izzuddin M 
Teo, Wei Ting
Li, Sarah Weiling
Biswas, Arijit 
Yong, Eu Leong 
Chong, Yap Seng 
Tan, Kelvin 
Kramer, Michael S 
Keywords: Science & Technology
Life Sciences & Biomedicine
Nursing
Obstetrics & Gynecology
Pediatrics
age-adjusted average annual percent change
cesarean birth
Singapore
PREGNANCY OUTCOMES
NEONATAL-MORTALITY
PERINATAL HEALTH
DELIVERY RATES
GLOBAL SURVEY
SECTION
COSTS
WOMEN
Issue Date: 1-Dec-2018
Publisher: WILEY
Citation: Chi, Claudia, Pang, Deanette, Aris, Izzuddin M, Teo, Wei Ting, Li, Sarah Weiling, Biswas, Arijit, Yong, Eu Leong, Chong, Yap Seng, Tan, Kelvin, Kramer, Michael S (2018-12-01). Trends and predictors of cesarean birth in Singapore, 2005-2014: A population-based cohort study. BIRTH-ISSUES IN PERINATAL CARE 45 (4) : 399-408. ScholarBank@NUS Repository. https://doi.org/10.1111/birt.12341
Abstract: Background: Rates of cesarean birth have continued to rise in many high-income countries. We examined the temporal trends and predictors of cesarean birth in Singapore. Methods: Linked hospitalization and Birth Registry data were used to examine all live births to Singaporean citizens and permanent residents between January 1, 2005 and December 31, 2014 (n = 342 932 births). We calculated cesarean rates and age-adjusted average annual percent change (AAPC) in those rates and used sequential multivariable regression modeling to assess the contribution of changes in predictors to the change in cesarean rates over time. Results: The overall cesarean rate in Singapore rose from 32.2% in 2005 to 37.4% in 2014. Among singleton, cephalic, term pregnancies, the two major predictions of cesarean were nulliparity and previous cesarean, each accounting for just over one-third of all cesareans. Higher AAPC was observed in nulliparous women of Indian ethnicity (0.74% [95% confidence interval 0.68-0.80]) compared with Chinese (0.62% [0.60-0.65]) or Malay women (0.63% [0.59-0.68]), and in women who delivered in private hospitals (0.62% [0.60-0.64]) compared with those delivered under subsidized care in public hospitals (0.58% [0.52-0.63]). Parity and education had the largest influences on cesarean birth trend (attenuation of AAPC from 0.62% [0.59-0.66] to 0.39% [0.38-0.40] after adjustment). Conclusion: Cesarean birth has continued to rise at a steady rate in Singapore. Strategies to curb this temporal increase include avoidance of medically unnecessary primary cesarean and attempts at trial of labor and vaginal delivery among women with a history of prior cesarean.
Source Title: BIRTH-ISSUES IN PERINATAL CARE
URI: https://scholarbank.nus.edu.sg/handle/10635/205817
ISSN: 07307659
1523536X
DOI: 10.1111/birt.12341
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