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Das et al. | Journal of Clinical and Translational Research 2024; 10(3): 219-228 223
private and public hospitals. Conversely, neonatal mortalities mothers aged 15 – 19 years old during delivery as the reference
were 0.88 times lower in public hospitals compared to private category, it was observed that mothers aged 25 – 29 years old
hospitals for normal births. This could be due to the preferences reported a lower risk of neonatal mortality from normal births
of private hospital doctors to perform cesarean sections over compared to cesarean births. Mothers, who gave birth more
normal deliveries, thereby significantly increasing neonatal and than 24 months after a preceding birth, reported significantly
infant mortalities of normal births in private hospitals. With lower risks of neonatal and infant mortalities compared to those
who gave birth less than 24 months after a preceding birth.
Birth orders of more than the third births were at significantly
45 Cesarean delivery
40.2 higher risks of neonatal and infant mortalities (i.e., 1.23 and
40 Normal delivery 36.3 1.32 times, respectively) for cesarean births compared to
35 27.1 normal births. Newborns from the “poorer” households were
Percentage (%) 25 21 16.8 23.2 at a higher risk of neonatal and infant mortalities compared to
30
newborns from the “richest” households for both normal and
20
cesarean births. In addition, the risk of neonatal mortality was
15
10 significantly lower for normal births delivered by doctors than
nurses (OR: 0.91 vs. 0.93).
5
0 4. Discussion
Stunting Wasting Underweight
Child growth
The effect of cesarean deliveries on child health and the
Figure 1. Impact of birth delivery method on child growth. higher cost associated with cesarean deliveries compared to

Table 4. OR and 95% CI for neonatal and infant mortalities based on the delivery method according to different demographic and socioeconomic
backgrounds in India (2015 – 2016)
Background Mortality, OR (95% CI)
Neonatal Infant
Cesarean Normal Cesarean Normal
Place of delivery
Public 0.24 (0.17 – 0.34)*** 0.88 (0.81 – 0.96)*** 0.28 (0.20 – 0.39)*** 0.89 (0.83 – 0.95)***
Private 0.25 (0.17 – 0.35)*** 1.33 (1.21 – 1.47)*** 0.28 (0.20 – 0.39)*** 1.20 (1.10 – 1.31)***
Mother’s age (years)
15 – 19 ® - - - -
20 – 24 0.83 (0.57 – 1.19) 0.77 (0.68 – 0.88)*** 0.89 (0.63 – 1.25) 0.73 (0.65 – 0.82)***
25 – 29 0.78 (0.54 – 1.13) 0.64 (0.56 – 0.73)*** 0.86 (0.61 – 1.21) 0.62 (0.56 – 0.70)***
>30 0.77 (0.52 – 1.13) 0.68 (0.60 – 0.79)*** 0.86 (0.60 – 1.23) 0.68 (0.61 – 0.77)***
Preceding birth interval (months)
<24 ® - - - -
≥24 0.74 (0.61 – 0.91)*** 0.53 (0.50 – 0.57)*** 0.77 (0.64 – 0.92) *** 0.53 (0.50 – 0.56)***
Birth order
1 ® - - - -
2 0.74 (0.63 – 0.88)*** 0.58 (0.54 – 0.62)*** 0.84 (0.72 – 0.96) ** 0.61 (0.58 – 0.65)***
>3 1.23 (1.01 – 1.49)** 0.70 (0.65 – 0.76)*** 1.32 (1.11 – 1.56) *** 0.80 (0.75 – 0.85)***
Place of residence
Urban ® - - - -
Rural 1.05 (0.90 – 1.22) 1.02 (0.95 – 1.10) 1.04 (0.91 – 1.18) 1.01 (0.94 – 1.07)
Household wealth
Poorest ® - - - -
Poorer 0.82 (0.66 – 1.02)* 0.84 (0.79 – 0.89)*** 0.82 (0.67 – 1.00)* 0.86 (0.82 – 0.91)***
Middle 0.60 (0.48 – 0.74)*** 0.68 (0.64 – 0.74)*** 0.61 (0.50 – 0.74)*** 0.73 (0.69 – 0.78)***
Richer 0.45 (0.36 – 0.57)*** 0.57 (0.52 – 0.63)*** 0.47 (0.38 – 0.57)*** 0.62 (0.57 – 0.67)***
Richest 0.37 (0.29 – 0.47)*** 0.40 (0.36 – 0.46)*** 0.36 (0.29 – 0.44)*** 0.44 (0.39 – 0.48)***
Birth delivered by
Doctor ® 0.79 (0.66 – 0.94)** 0.91 (0.88 – 1.00)** 0.81 (0.70 – 0.95)*** 0.89 (0.84 – 0.93)***
Nurse 0.99 (0.86 – 1.13) 0.93 (0.87 – 1.00)** 0.95 (0.85 – 1.07) 0.94 (0.89 – 0.99)**
® Denotes the reference category; ***P<0.01; **P<0.05; *P<0.10.
Abbreviations: CI: Confidence interval; SD: Standard deviation.
DOI: https://doi.org/10.36922/jctr.22.00239