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Cesarean Delivery Rates Revisiting a 3-Decades-Old Dogma

D’Alton, Mary E. MD; Hehir, Mark P. MD

doi: 10.1097/01.aoa.0000504696.75074.63
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Commentary

(JAMA 2015;314(21):2238–2240)

Cesarean delivery rates have become a major public health concern. Because of some studies showing that higher rates could be associated with negative outcomes, including increased maternal morbidity and mortality and neonatal intensive care unit admission along with unnecessary consumption of health care resources, there have been efforts in some developed countries to decrease national cesarean delivery rates. A cross-sectional, geographical study was conducted by Molina and colleagues estimating annual cesarean delivery rates in World Health Organization (WHO) member countries from data collected during the period 2005 to 2012. The research estimated that, in 2012, there were 22.9 million cesarean deliveries worldwide. The combined data were then analyzed in association with maternal and neonatal mortality rates from those countries where these rates were available. The study concluded that a cesarean delivery rate of 19% resulted in the best outcomes in terms of optimal levels of maternal and neonatal mortality.

Department of Obstetrics and Gynecology, New York Presbyterian Hospital, Columbia University College of Physicians and Surgeons, New York, NY

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