Table 3 Cesarean section rates by obstetric characteristics according to the modified Robson classification by group allocation and period, Shanghai, China
| Â | Intervention group (10 hospitals) | Control group (10 hospitals) | Effect estimates | |||||
|---|---|---|---|---|---|---|---|---|
Cesarean by indications (modified Robson classification) | Baseline (N = 5498) | Evaluation (N = 5092) | Rate change% | Baseline (N = 5254) | Evaluation (N = 5429) | Rate change% | Adjusted OR (95%CI) | p value |
1. Nulliparous, singleton, cephalic, ≥ 37 weeks, spontaneous labor | ||||||||
 Total no. | 1586 | 1100 |  | 1619 | 1259 |  |  |  |
 Cs, no.(%) | 129 (8.1) | 89 (8.1) | 0 | 160 (9.9) | 101 (8.0) | −1.9 | 1.24 (0.71, 2.17) | 0.44 |
2. Nulliparous, singleton, cephalic, ≥ 37 weeks, induced labor | ||||||||
 Total no. | 717 | 761 |  | 660 | 805 |  |  |  |
 Cs, no.(%) | 160 (22.3) | 132 (17.4) | −4.9 | 141 (21.4) | 148 (18.4) | −3.0 | 0.87 (0.52, 1.46) | 0.60 |
3. Nulliparous, singleton, cephalic, ≥ 37 weeks, CS before labor | ||||||||
 Total no. | 819 | 650 |  | 762 | 714 |  |  |  |
 Cs, no.(%) | 819 (100) | 650 (100) | 0 | 762 (100) | 714 (100) | 0 | NA | NA |
4. Multiparous, singleton, cephalic, ≥ 37 weeks, without a previous CS, spontaneous labor | ||||||||
 Total no. | 796 | 764 |  | 753 | 886 |  |  |  |
 Cs, no.(%) | 22 (2.8) | 11 (1.4) | −1.4 | 13 (1.7) | 10 (1.1) | −0.6 | 0.85 (0.27, 2.72) | 0.78** |
5. Multiparous, singleton, cephalic, ≥ 37 weeks, without a previous CS, induced labor | ||||||||
 Total no. | 159 | 329 |  | 166 | 294 |  |  |  |
 Cs, no.(%) | 11 (6.9) | 21 (6.4) | −0.5 | 11 (6.6) | 14 (4.8) | −1.8 | 1.03 (0.32, 3.35) | 0.96** |
6. Multiparous, singleton, cephalic, ≥ 37 weeks, without a previous CS, CS before labor | ||||||||
 Total no. | 97 | 103 |  | 96 | 136 |  |  |  |
 Cs, no.(%) | 97 (100) | 103 (100) | 0 | 96 (100) | 136 (100) | 0 | NA | NA |
7. Multiparous, singleton, cephalic, ≥ 37 weeks, with a previous CS | ||||||||
 Total no. | 688 | 853 |  | 664 | 842 |  |  |  |
 Cs, no.(%) | 666 (96.8) | 827 (97.0) | 0.2 | 631 (95.0) | 818 (97.2) | 2.2 | 0.52 (0.21, 1.29) | 0.15** |
8. Singleton, breech, transverse or oblique lie# | ||||||||
 Total no. | 284 | 230 |  | 222 | 206 |  |  |  |
 Cs, no.(%) | 237 (83.5) | 202 (87.8) | 4.3 | 213 (96.0) | 197 (95.6) | −0.4 | 2.05 (0.4, 10.65) | 0.39 |
9. Multiple pregnancy (twins or higher-order multiples) | ||||||||
 Total no. | 113 | 90 |  | 66 | 64 |  |  |  |
 Cs, no.(%) | 108 (95.6) | 84 (93.3) | −2.3 | 58 (87.9) | 59 (92.2) | 4.3 | 0.25 (0.02, 3.25) | 0.28** |
10. Singleton, cephalic, < 37 weeks | ||||||||
 Total no. | 217 | 201 |  | 231 | 217 |  |  |  |
 Cs, no.(%) | 80 (36.9) | 88 (43.8) | 6.9 | 91 (39.4) | 107 (49.3) | 9.9 | 0.7 (0.34, 1.43) | 0.32 |
99. Unknown | ||||||||
 Total no. | 22 | 11 |  | 15 | 6 |  |  |  |
 Cs, no.(%) | 7 (31.8) | 2 (18.2) | −13.6 | 5 (33.3) | 1 (16.7) | −16.6 | NA | NA |