Caesarean Delivery and Postpartum Maternal Mortality: A Population-Based Case Control Study in Brazil.
BACKGROUND:Cesarean delivery rates continue to increase worldwide and reached 57% in Brazil in 2014. Although the safety of this surgery has improved in the last decades, this trend is a concern because it carries potential risks to women's health and may be a modifiable risk factor of maternal...
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doaj-b89f7853df854ec5b41c3edc5c426e6a2020-11-25T01:38:00ZengPublic Library of Science (PLoS)PLoS ONE1932-62032016-01-01114e015339610.1371/journal.pone.0153396Caesarean Delivery and Postpartum Maternal Mortality: A Population-Based Case Control Study in Brazil.Ana Paula Esteves-PereiraCatherine Deneux-TharauxMarcos Nakamura-PereiraMonica SaucedoMarie-Hélène Bouvier-ColleMaria do Carmo LealBACKGROUND:Cesarean delivery rates continue to increase worldwide and reached 57% in Brazil in 2014. Although the safety of this surgery has improved in the last decades, this trend is a concern because it carries potential risks to women's health and may be a modifiable risk factor of maternal mortality. This paper aims to investigate the risk of postpartum maternal death directly associated with cesarean delivery in comparison to vaginal delivery in Brazil. METHODS:This was a population-based case-control study performed in eight Brazilian states. To control for indication bias, deaths due to antenatal morbidity were excluded. We included 73 cases of postpartum maternal deaths from 2009-2012. Controls were selected from the Birth in Brazil Study, a 2011 nationwide survey including 9,221 postpartum women. We examined the association of cesarean section and postpartum maternal death by multivariate logistic regression, adjusting for confounders. RESULTS:After controlling for indication bias and confounders, the risk of postpartum maternal death was almost three-fold higher with cesarean than vaginal delivery (OR 2.87, 95% CI 1.63-5.06), mainly due to deaths from postpartum hemorrhage and complications of anesthesia. CONCLUSION:Cesarean delivery is an independent risk factor of postpartum maternal death. Clinicians and patients should consider this fact in balancing the benefits and risks of the procedure.http://europepmc.org/articles/PMC4830588?pdf=render |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Ana Paula Esteves-Pereira Catherine Deneux-Tharaux Marcos Nakamura-Pereira Monica Saucedo Marie-Hélène Bouvier-Colle Maria do Carmo Leal |
spellingShingle |
Ana Paula Esteves-Pereira Catherine Deneux-Tharaux Marcos Nakamura-Pereira Monica Saucedo Marie-Hélène Bouvier-Colle Maria do Carmo Leal Caesarean Delivery and Postpartum Maternal Mortality: A Population-Based Case Control Study in Brazil. PLoS ONE |
author_facet |
Ana Paula Esteves-Pereira Catherine Deneux-Tharaux Marcos Nakamura-Pereira Monica Saucedo Marie-Hélène Bouvier-Colle Maria do Carmo Leal |
author_sort |
Ana Paula Esteves-Pereira |
title |
Caesarean Delivery and Postpartum Maternal Mortality: A Population-Based Case Control Study in Brazil. |
title_short |
Caesarean Delivery and Postpartum Maternal Mortality: A Population-Based Case Control Study in Brazil. |
title_full |
Caesarean Delivery and Postpartum Maternal Mortality: A Population-Based Case Control Study in Brazil. |
title_fullStr |
Caesarean Delivery and Postpartum Maternal Mortality: A Population-Based Case Control Study in Brazil. |
title_full_unstemmed |
Caesarean Delivery and Postpartum Maternal Mortality: A Population-Based Case Control Study in Brazil. |
title_sort |
caesarean delivery and postpartum maternal mortality: a population-based case control study in brazil. |
publisher |
Public Library of Science (PLoS) |
series |
PLoS ONE |
issn |
1932-6203 |
publishDate |
2016-01-01 |
description |
BACKGROUND:Cesarean delivery rates continue to increase worldwide and reached 57% in Brazil in 2014. Although the safety of this surgery has improved in the last decades, this trend is a concern because it carries potential risks to women's health and may be a modifiable risk factor of maternal mortality. This paper aims to investigate the risk of postpartum maternal death directly associated with cesarean delivery in comparison to vaginal delivery in Brazil. METHODS:This was a population-based case-control study performed in eight Brazilian states. To control for indication bias, deaths due to antenatal morbidity were excluded. We included 73 cases of postpartum maternal deaths from 2009-2012. Controls were selected from the Birth in Brazil Study, a 2011 nationwide survey including 9,221 postpartum women. We examined the association of cesarean section and postpartum maternal death by multivariate logistic regression, adjusting for confounders. RESULTS:After controlling for indication bias and confounders, the risk of postpartum maternal death was almost three-fold higher with cesarean than vaginal delivery (OR 2.87, 95% CI 1.63-5.06), mainly due to deaths from postpartum hemorrhage and complications of anesthesia. CONCLUSION:Cesarean delivery is an independent risk factor of postpartum maternal death. Clinicians and patients should consider this fact in balancing the benefits and risks of the procedure. |
url |
http://europepmc.org/articles/PMC4830588?pdf=render |
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