Cesarean delivery rate and staffing levels of the maternity unit

Saad Zbiri, Patrick Rozenberg (), François Goffinet and Carine Milcent
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Saad Zbiri: RISCQ - Risques cliniques et sécurité en santé des femmes et en santé périnatale - UVSQ - Université de Versailles Saint-Quentin-en-Yvelines
Patrick Rozenberg: Service de gynécologie et obstétrique [CHI Poissy-Saint Germain] - CHI Poissy-Saint-Germain, RISCQ - Risques cliniques et sécurité en santé des femmes et en santé périnatale - UVSQ - Université de Versailles Saint-Quentin-en-Yvelines
François Goffinet: Service de Gynécologie et Obstétrique [Cochin] - Hôpital Cochin [AP-HP] - AP-HP - Assistance publique - Hôpitaux de Paris (AP-HP), CRESS - U1153 - Equipe 1 : EPOPé - Épidémiologie Obstétricale, Périnatale et Pédiatrique - UPD5 - Université Paris Descartes - Paris 5 - CRESS (U1153 / UMR_A_1125 / UMR_S_1153) - Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité - INRA - Institut National de la Recherche Agronomique - UPD7 - Université Paris Diderot - Paris 7 - UPD5 - Université Paris Descartes - Paris 5 - USPC - Université Sorbonne Paris Cité - INSERM - Institut National de la Santé et de la Recherche Médicale, Hôpital Cochin [AP-HP] - AP-HP - Assistance publique - Hôpitaux de Paris (AP-HP), UPD5 - Université Paris Descartes - Paris 5

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Abstract: Objective To investigate whether staffing levels of maternity units affect prelabor urgent, elective, and intrapartum cesarean delivery rates. Methods This population-based retrospective cohort study covers the deliveries of the 11 hospitals of a French perinatal network in 2008–2014 (N = 102 236). The independent variables were women's demographic and medical characteristics as well as the type, organization, and staffing levels for obstetricians, anesthesiologists, and midwives of each maternity unit. Bivariate and multivariate analyses were conducted with multilevel logistic models. Results Overall, 23.9% of the women had cesarean deliveries (2.4% urgent before labor, 10% elective, and 11.5% intrapartum). Independently of individual- and hospital-level factors, the level of obstetricians, measured by the number of full-time equivalent persons (i.e., 35 working hours per week) per 100 deliveries, was negatively associated with intrapartum cesarean delivery (adjusted odds ratio, aOR 0.55, 95% confidence interval, CI 0.36–0.83, P-value = 0.005), and the level of midwives negatively associated with elective cesarean delivery (aOR 0.79, 95% CI 0.69–0.90, P-value

Date: 2018-11
Note: View the original document on HAL open archive server: https://shs.hal.science/halshs-01960301v1
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Published in PLoS ONE, 2018, 13 (11), pp.e0207379. ⟨10.1371/journal.pone.0207379⟩

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Journal Article: Cesarean delivery rate and staffing levels of the maternity unit (2018)
Working Paper: Cesarean delivery rate and staffing levels of the maternity unit (2018)
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Persistent link: https://EconPapers.repec.org/RePEc:hal:pseptp:halshs-01960301

DOI: 10.1371/journal.pone.0207379

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