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    Changes in caesarean delivery rates in Western Australia from 1995 to 2010 by gestational age at birth

    Access Status
    Fulltext not available
    Authors
    Einarsdöttir, K.
    Ball, Stephen
    Pereira, Gavin
    Griffin, C.
    Jacoby, P.
    De Klerk, N.
    Leonard, H.
    Stanley, F.
    Date
    2015
    Type
    Journal Article
    
    Metadata
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    Citation
    Einarsdöttir, K. and Ball, S. and Pereira, G. and Griffin, C. and Jacoby, P. and De Klerk, N. and Leonard, H. et al. 2015. Changes in caesarean delivery rates in Western Australia from 1995 to 2010 by gestational age at birth. Paediatric and Perinatal Epidemiology. 29 (4): pp. 290-298.
    Source Title
    Paediatric and Perinatal Epidemiology
    DOI
    10.1111/ppe.12202
    ISSN
    0269-5022
    URI
    http://hdl.handle.net/20.500.11937/10050
    Collection
    • Curtin Research Publications
    Abstract

    © 2015 John Wiley & Sons Ltd. Background The caesarean delivery rate in the developed world has been increasing. It is not well understood how caesarean delivery rates have changed by gestational age at birth in Western Australia, particularly in relation to the introduction of the early-term delivery guidelines in Australia in 2006. Methods Data from the Western Australian Midwives Notification System were used to identify 193-136 singletons born to primiparous women at 34-42 weeks' gestation during 1995-2010. Caesarean delivery rates were calculated by gestational age group (34-36 weeks, 37-38 weeks, and 39-42 weeks) and stratified into pre-labour and in-labour caesarean delivery. The average annual per-cent change (AAPC) for the caesarean delivery rates was calculated using joinpoint regression. Log-binomial regression was used to estimate the risk of having a caesarean delivery while adjusting for maternal and antenatal factors. Results Caesarean delivery rates rose steadily from 1995 to 2005 (AAPC-=-5.9%, [95% confidence interval (CI) 4.9, 6.9]), but stabilised since then (AAPC-=-0.9%, [95% CI -1.9, 3.8]). The rate of in-labour caesarean deliveries rose consistently from 1995 to 2010 across all gestational age groups. The pre-labour caesarean delivery rate rise was most dominant at 37-38 weeks' gestation from 1995 to 2005 (AAPC-=-6.8%, [95% CI 5.4, 8.2]), but declined during 2006-10 (AAPC-=-4.5, [95% CI -6.7, -2.3]), while at the same time the rate at 39-42 weeks rose slightly. Conclusions The rise in pre-labour caesarean deliveries during 1995-2005 occurred predominantly at 37-38 weeks' gestation, but declined again from 2006 to 2010. This suggests that the recently developed Australian early-term delivery guidelines may have had some success in reducing early-term deliveries in Western Australia.

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