Page 72 - IJPS-7-1

International Journal of Population Studies

RESEARCH ARTICLE

Risk factors for cesarean section in

women of urban Puducherry, India: A

matched case–control study

Sathish Rajaa , Akkilangunta Sujiv , and Sitanshu Sekar Kar *
1
2
1
1 Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate
Medical Education and Research, Puducherry, India
2 Department of Preventive and Social Medicine, All India Institute of Medical Sciences,
Nagpur, Maharashtra, India

Abstract: Cesarean section (CS) is generally performed either to ensure maternal and
child safety when vaginal delivery is not possible. The WHO has indicated that CS rates
of more than 10% are considered overutilization. Increased CS rates can cause an increase
in postpartum antibiotic treatment and longer hospital stay. In this research, we conducted
a matched case–control study, including all women who gave birth through CS and resided
ARTICLE INFO
in the study area over a 3-year period before the survey as cases and similar age- and year-
Received: March 3, 2022 matched women who had normal vaginal delivery during the same period as controls. The data
Accepted: August 30, 2022 were collected using a semi-structured pro forma through personal interviews and verified with
Published: September 13, 2022 discharge cards. We obtained a sample of 140 women (70 matched cases and controls) as study

*CORRESPONDING AUTHOR participants. Our results show that unadjusted analysis revealed socioeconomic status, history
of gestational diabetes mellitus, previous lower segment CS (LSCS), and malpresentation
Sitanshu Sekar Kar, emerged as risk factors, whereas in the adjusted analysis, we observed that previous LSCS
Department of Preventive and
Social Medicine, Jawaharlal (aOR 45.4 [4.3 – 483.6]), malpresentation (aOR 11.0 [1.6 – 73.8]), and belonging to middle
Institute of Postgraduate (aOR 3.3 [1.0 – 10.8]) and upper class (aOR 23.55 [CI: 1.2 – 463.8]) remained as independent
Medical Education and risk factors. Our study identified independent risk factors for CS that needs to be tackled for
Research, Puducherry, India. bringing down the CS rates.
drsitanshukar@gmail.com
Keywords: Antenatal care; Cesarean section; India; Matched case–control design;
CITATION
National Family Health Survey; Risk factors
Rajaa S, Sujiv A, Kar, S.S.
(2021). Risk factors for 1. Introduction
cesarean section in women
of urban Puducherry, India: A Cesarean section (CS or C-section) is a surgical procedure performed either to ensure
matched case–control study.
International Journal of maternal and child safety when vaginal delivery is not possible (emergency CS) or as an
Population Studies, 7(1):66-74. elective procedure (planned CS). With advancement in anesthetic procedures and improved
doi: 10.36922/ijps.v7i1.290 surgical techniques, the morbidity and mortality of CSs have reduced. The WHO considers
Copyright: ©2022 Rajaa et al. the proportion of CS to the total births as one of the vital indicators of emergency obstetric
This is an Open-Access article care (Arjun, 2008). A CS rate higher than 10% is regarded as over utilization, that is, for other
distributed under the terms than life-saving reasons (Wehberg et al., 2018). Both developed and developing countries
of the Creative Commons have reported about 27% CS in 2013 (Betran et al., 2021). Many developing countries such
Attribution-Non-Commercial
4.0 International License as China and Bangladesh have reported a tremendous increase in CS birth rates in the past
(http://creativecommons.org/ two decades (Ahmmed et al., 2021; Li et al., 2020), thereby making it a serious public health
licenses/by-nc/4.0/), permitting issue (Lauer et al., 2010). Several studies conducted in different parts of the world have
all non-commercial use, shouldered the above statement (Betran et al., 2007; Betran et al., 2016; Betran et al., 2021).
distribution, and reproduction
in any medium, provided the A WHO global survey has revealed that CS is associated with an increase in postpartum
original work is properly cited. antibiotic treatment, greater complications in subsequent pregnancies, longer hospital

66 International Journal of Population Studies | 2021, Volume 7, Issue 1