Table 2 Effects of the multifaceted intervention on cesarean section rate, Shanghai, China
| Â | Intervention group (10 hospitals) | Control group (10 hospitals) | Effect of the intervention | |||||||
|---|---|---|---|---|---|---|---|---|---|---|
|  | Baseline (N = 5498) | Evaluation (N = 5092) | Rate change% | p value | Baseline (N = 5254) | Evaluation (N = 5429) | Rate change% | p value | Adjusted OR (95%CI) | p value |
Cesarean delivery, no. (%) | 2336 (42.5) | 2209 (43.4) | 0.9 | 0.32 | 2181 (41.5) | 2303 (42.4) | 0.9 | 0.47 | 0.92 (0.73, 1.15) | 0.44 |
Risk level of pregnancy | ||||||||||
 Low | ||||||||||
  Total no. | 2830 | 2420 |  |  | 2671 | 2711 |  |  |  |  |
  Cesarean delivery, no. (%) | 760 (26.9) | 563 (23.3) | −3.6 | 0.20 | 691 (25.9) | 626 (23.1) | −2.8 | 0.36 | 0.96 (0.74, 1.25) | 0.75 |
 High | ||||||||||
  Total no. | 2668 | 2672 |  |  | 2583 | 2718 |  |  |  |  |
  Cesarean delivery, no. (%) | 1576 (59.1) | 1646 (61.6) | 2.5 | 0.97 | 1490 (57.7) | 1677 (61.7) | 4.0 | 0.14 | 0.9 (0.71, 1.14) | 0.38 |
Maternal age | ||||||||||
 < 35 years | ||||||||||
  Total no. | 4854 | 4330 |  |  | 4705 | 4605 |  |  |  |  |
  Cesarean delivery, no. (%) | 1969 (40.6) | 1756 (40.6) | 0 | 0.25 | 1879 (39.9) | 1847 (40.1) | 0.2 | 0.63 | 0.9 (0.71, 1.13) | 0.36 |
 ≥ 35 years | ||||||||||
 Total no. | 533 | 678 |  |  | 494 | 739 |  |  |  |  |
 Cesarean delivery, no. (%) | 317 (59.5) | 413 (60.9) | 1.4 | 0.74 | 283 (57.3) | 418 (56.6) | −0.7 | 0.51 | 0.97 (0.58, 1.62) | 0.89 |
Number of previous cesarean deliveries | ||||||||||
 0 | ||||||||||
  Total no. | 4722 | 4134 |  |  | 4516 | 4496 |  |  |  |  |
  Cesarean delivery, no. (%) | 1594 (33.8) | 1289 (31.2) | −2.6 | 0.32 | 1489 (33.0) | 1403 (31.2) | −1.8 | 0.73 | 0.94 (0.74, 1.19) | 0.59 |
 ≥ 1 | ||||||||||
 Total no. | 768 | 952 |  |  | 727 | 930 |  |  |  |  |
 Cesarean delivery, no. (%) | 739 (96.2) | 920 (96.6) | 0.4 | 0.95 | 687 (94.5) | 900 (96.8) | 2.3 | 0.06 | 0.55 (0.25, 1.24) | 0.14** |
Parity | ||||||||||
 Primipara | ||||||||||
  Total no. | 3546 | 2837 |  |  | 3399 | 3064 |  |  |  |  |
  Cesarean delivery, no. (%) | 1405(39.6) | 1094 (38.6) | −1.0 | 0.56 | 1316 (38.7) | 1172 (38.3) | −0.4 | 0.86 | 0.98 (0.77, 1.25) | 0.87 |
 Multipara without a previous CS | ||||||||||
 Total no. | 1175 | 1298 |  |  | 1117 | 1432 |  |  |  |  |
 Cesarean delivery, no. (%) | 188 (16.0) | 195 (15.0) | −1.0 | 0.24 | 173 (15.5) | 231 (16.1) | 0.6 | 0.15 | 0.74 (0.49, 1.1) | 0.13 |
 Multipara with a previous CS or not | ||||||||||
 Total no. | 1949 | 2255 |  |  | 1852 | 2364 |  |  |  |  |
 Cesarean delivery, no. (%) | 929 (47.7) | 1115 (49.5) | 1.8 | 0.25 | 863 (46.6) | 1131 (47.8) | 1.2 | 0.045 | 0.75 (0.53, 1.05) | 0.09 |