SciELO - Scientific Electronic Library Online

 
vol.85 issue2Exposure to Lindane, other Pesticides and Organochlorines in the General Population Barakaldo, SpainRelationship Between Tobacco Smoke and Dental Caries in School Children at the Valencian Country author indexsubject indexarticles search
Home Pagealphabetic serial listing  

Services on Demand

Journal

Article

Indicators

Related links

  • On index processCited by Google
  • Have no similar articlesSimilars in SciELO
  • On index processSimilars in Google

Share


Revista Española de Salud Pública

On-line version ISSN 2173-9110Print version ISSN 1135-5727

Abstract

MARQUEZ-CALDERON, Soledad; RUIZ-RAMOS, Miguel; JUAREZ, Sol  and  LIBRERO LOPEZ, Julián. Caesarean Delivery in Andalusia, Spain: Relationship with Social, Clinical and Health Services Factors (2007-2009). Rev. Esp. Salud Publica [online]. 2011, vol.85, n.2, pp.205-215. ISSN 2173-9110.

Background: Increasing trend and geographical variations in the use of caesarean section suggest the influence of non-clinical factors. The objective was to describe the use of caesarean section in the Andalusian region in Spain by exploring the role of social, clinical, and health services variables. Methods: A cross-sectional study was carried out using vital statistics. It involves all births occurred in Andalusia during the period of 2007-2009. The dependent variable was the use of caesarean section and the set of covariates were classified into three groups: those with a clinical meaning, those related to the health services organization, and those with a social significance. Multivariate logistic regressions were used. Results: In the data set of 293,558 births, the prevalence of caesarean delivery was 24.8%. The multivariate analysis highlights the labour complications as the clinical variable with the highest odds ratio (OR=19.36). Regarding the health services variables, the odds of experiencing a caesarean delivery were 55% higher on weekdays than on weekends. Cádiz was the province with the highest OR for caesarean section (comparison between Cádiz and Almería: OR=1,21) where the ratio between births in public and private hospitals was 3.7. The frequency of caesarean section was 34% higher in women with third level education than those with no education. Conclusions: Labour complication is the most influential variable for caesarean section. Caesarean birth rate is above the accepted standards for all social classes and increases with educational level. Inter-provincial differences reflect different patterns with regard to the use of private medicine.

Keywords : Cesarean section; Health care quality, access and evaluation; Health social inequalities.

        · abstract in Spanish     · text in Spanish     · Spanish ( pdf )

 

Creative Commons License All the contents of this journal, except where otherwise noted, is licensed under a Creative Commons Attribution License