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Table 4 Relationship between mode of delivery and severe maternal outcomes by continent

From: Caesarean section without medical indications is associated with an increased risk of adverse short-term maternal outcomes: the 2004-2008 WHO Global Survey on Maternal and Perinatal Health

Severe Maternal Outcomes No (%) Adjusted OR [95%CI]
Africa †   
   Spontaneous (reference) 1011/69,364 (1.46) 1 to
   Operative 151/2,298 (6.57) 2.58 (2.12-3.15)
   Antepartum without indications 14/63(22.22) 71.29 (32.06 to 158.55)
   Intrapartum without indications 36/202(17.82) 40.67 (24.56-67.33)
   Antepartum with indications 960/2,399(40.02) 88.61 (74.88 to 104.86)
   Intrapartum with indications 1,942/7,396(26.26) 54.26 (47.81 to 61.59)
Americas ††   
   Spontaneous (reference) 946/61130 (1.55) 1
   Operative 50/1533 (3.26) 2.2 (1.62 to 2.99)
   Antepartum without indications 6/157(3.82) 1.94 (0.77 to 4.9)
   Intrapartum without indications 10/194(5.15) 4 (2.05 to 7.82)
   Antepartum with indications 803/13759(5.84) 3.04 (2.71 to 3.41)
   Intrapartum with indications 640/20120(3.18) 1.91 (1.71 to 2.13)
Asia †††   
   Spontaneous (reference) 1190/75057 (1.59) 1
   Operative 145/3465 (4.18) 1.91 (1.56 to 2.35)
   Antepartum without indications 8/1515(0.53) 2.14 (1.04 to 4.43)
   Intrapartum without indications 40/554(7.22) 12.86 (8.83 to 18.73)
   Antepartum with indications 689/10853(6.35) 8.09 (7.12 to 9.18)
   Intrapartum with indications 1941/16506(11.76) 11.61 (10.56 to 12.76)
  1. †Maternal age, Total number of years attended school, Primiparaous, Birth weight, Neonatal death or stillbirth, Caesarean section at last pregnancy, Pregnancy induced hypertension or preeclampsia or eclampsia or chronic hypertension, Suspected fetal growth impairment, Vaginal bleeding in 2nd half of pregnancy, Referred for complication related to pregnancy or delivery, Any other medical complication during pregnancy (excluding chronic hypertension), Country, Incentive for caesarean section
  2. ††Birth weight, Prelabour rupture of membranes, Pregnancy induced hypertension or preeclampsia or eclampsia or chronic hypertension, Vaginal bleeding in 2nd half of pregnancy, Any antenatal antibiotic treatment, Referred for complication related to pregnancy or delivery, Induced labour, HIVPOS, Any other medical complication during pregnancy (excluding chronic hypertension) and Incentive for caesarean section
  3. ††† Maternal age, Total number of years attended school, Primiparous, Birth weight, Neonatal death or stillbirth, Prelabour rupture of membranes, Pregnancy induced hypertension or preeclampsia or eclampsia or chronic hypertension, Vaginal bleeding in 2nd half of pregnancy, Breech or other non-cephalic precentation, Referred for complication related to pregnancy or delivery, HIVPOS, Any other medical complication during pregnancy (excluding chronic hypertension), Country and Complexity of index
  4. (Differently from the previous Asian specific analysis [7], the severe maternal outcomes included in this analysis are: death, admission to ICU, blood transfusion and hysterectomy)
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