Prevalence of Caesarean sections in Enugu, southeast Nigeria

Analysis of data from the Healthy Beginning Initiative

Jayleen K.L. Gunn, John E Ehiri, Elizabeth T Jacobs, Kacey C Ernst, Sydney D Pettygrove, Katherine E. Center, Alice Osuji, Amaka G. Ogidi, Nnabundo Musei, Michael C. Obiefune, Chinenye O. Ezeanolue, Echezona E. Ezeanolue

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background In order to meet the Sustainable Development Goal to decrease maternal mortality, increased access to obstetric interventions such as Caesarean sections (CS) is of critical importance. As a result of women's limited access to routine and emergency obstetric services in Nigeria, the country is a major contributor to the global burden of maternal mortality. In this analysis, we aim to establish rates of CS and determine socioeconomic or medical risk factors associated with having a CS in Enugu, southeast Nigeria. Methods Data for this study originated from the Healthy Beginning Initiative study. Participant characteristics were obtained from 2300 women at baseline via a semi-structured questionnaire. Only women between the ages of 17-45 who had singleton deliveries were retained for this analysis. Post-delivery questionnaires were used to ascertain mode-of-delivery. Crude and adjusted logistic regressions with Caesarean as the main outcome are presented. Results In this sample, 7.22% women had a CS. Compared to women who lived in an urban setting, those who lived in a rural setting had a significant reduction in the odds of having a CS (aOR: 0.58; 0.38-0.89). Significantly higher odds of having a CS were seen among those with high peripheral malaria parasitemia compared to those with low parasitemia (aOR: 1.54; 1.04-2.28) Conclusion This study revealed that contrary to the increasing trend in use of CS in low-income countries, women in this region of Nigeria had limited access to this intervention. Increasing age and socioeconomic proxies for income and access to care (e.g., having a tertiary-level education, full-time employment, and urban residence) were shown to be key determinants of access to CS. Further research is needed to ascertain the obstetric conditions under which women in this region receive CS, and to further elucidate the role of socioeconomic factors in accessing CS.

Original languageEnglish (US)
Article number0174369
JournalPLoS One
Volume12
Issue number3
DOIs
StatePublished - Mar 1 2017

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Obstetrics
cesarean section
Nigeria
Cesarean Section
data analysis
Logistics
Sustainable development
Education
Parasitemia
Maternal Mortality
parasitemia
socioeconomics
income
questionnaires
socioeconomic factors
Conservation of Natural Resources
educational status
Proxy
sustainable development
malaria

ASJC Scopus subject areas

  • Medicine(all)
  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

Cite this

Prevalence of Caesarean sections in Enugu, southeast Nigeria : Analysis of data from the Healthy Beginning Initiative. / Gunn, Jayleen K.L.; Ehiri, John E; Jacobs, Elizabeth T; Ernst, Kacey C; Pettygrove, Sydney D; Center, Katherine E.; Osuji, Alice; Ogidi, Amaka G.; Musei, Nnabundo; Obiefune, Michael C.; Ezeanolue, Chinenye O.; Ezeanolue, Echezona E.

In: PLoS One, Vol. 12, No. 3, 0174369, 01.03.2017.

Research output: Contribution to journalArticle

Gunn, Jayleen K.L. ; Ehiri, John E ; Jacobs, Elizabeth T ; Ernst, Kacey C ; Pettygrove, Sydney D ; Center, Katherine E. ; Osuji, Alice ; Ogidi, Amaka G. ; Musei, Nnabundo ; Obiefune, Michael C. ; Ezeanolue, Chinenye O. ; Ezeanolue, Echezona E. / Prevalence of Caesarean sections in Enugu, southeast Nigeria : Analysis of data from the Healthy Beginning Initiative. In: PLoS One. 2017 ; Vol. 12, No. 3.
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abstract = "Background In order to meet the Sustainable Development Goal to decrease maternal mortality, increased access to obstetric interventions such as Caesarean sections (CS) is of critical importance. As a result of women's limited access to routine and emergency obstetric services in Nigeria, the country is a major contributor to the global burden of maternal mortality. In this analysis, we aim to establish rates of CS and determine socioeconomic or medical risk factors associated with having a CS in Enugu, southeast Nigeria. Methods Data for this study originated from the Healthy Beginning Initiative study. Participant characteristics were obtained from 2300 women at baseline via a semi-structured questionnaire. Only women between the ages of 17-45 who had singleton deliveries were retained for this analysis. Post-delivery questionnaires were used to ascertain mode-of-delivery. Crude and adjusted logistic regressions with Caesarean as the main outcome are presented. Results In this sample, 7.22{\%} women had a CS. Compared to women who lived in an urban setting, those who lived in a rural setting had a significant reduction in the odds of having a CS (aOR: 0.58; 0.38-0.89). Significantly higher odds of having a CS were seen among those with high peripheral malaria parasitemia compared to those with low parasitemia (aOR: 1.54; 1.04-2.28) Conclusion This study revealed that contrary to the increasing trend in use of CS in low-income countries, women in this region of Nigeria had limited access to this intervention. Increasing age and socioeconomic proxies for income and access to care (e.g., having a tertiary-level education, full-time employment, and urban residence) were shown to be key determinants of access to CS. Further research is needed to ascertain the obstetric conditions under which women in this region receive CS, and to further elucidate the role of socioeconomic factors in accessing CS.",
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