Abstract:

Caesarean section is an essential clinical obstetric intervention used to reduce maternal and foetal death. Several indications contribute to the decision-making to use CS as a delivery in the clinical environment. This study sought to determine the prevalence of CS at LEKMA Hospital in Ghana and the demographic and clinical history of mothers as predictors for the prevalence. Using a retrospective study design, data for all mothers who had previously given birth at the hospital’s obstetric and gynaecological department was used. Multiple logistic regression was applied and a p-value<0.05 with a 95% confidence interval (CI) for results using IBM-SPSS version 25. From the study, the prevalence of CS was 40.6% and the average age for SVD and CS were 28.3±5.94years and CS 29.6±5.50years respectively. The likelihood of those aged 36 years and above undergoing CS was notably higher (AOR; 2.84, 95%CI 1.41-5.3, p-value <0.0001) compared to those aged 26-30 (AOR; 2.45, 95%CI 1.49-4.00, p-value: 0.004) years and 31-35 (AOR; 1.65, 95% CI 0.94-2.90, p-value: 0.080) years. The results further indicated that the risk of undergoing CS was greater among mothers with parity of 1-2 (AOR: 1.56, 95%CI 1.02-2.41, p-value: 0.040). The prevalence of CS in the study is greater than the recommended prevalence per 100 births by the World Health Organization. The sociodemographic and clinical history of a pregnant woman influenced the mode of delivery such that the increase in gestational age and parity decreased the risk of CS. Whiles the educational status and age of the mothers at the time of birth increased the risk of CS delivery.

References:

[1] Zewude B, Siraw G, Adem Y. The Preferences of Modes of Child Delivery and Associated Factors Among Pregnant Women in Southern Ethiopia. Pragmatic Obs Res. 2022; Volume 13(July):59–73.

[2] Apanga PA, Awoonor-Williams JK. Predictors of caesarean section in northern Ghana: A case-control study. Pan Afr Med J. 2018; 29:1–11.

[3] Tsegaye H, Desalegne B, Wassihun B, Bante A, Fikadu K, Debalkie M, et al. Prevalence and associated factors of caesarean section in Addis Ababa hospitals, Ethiopia. Pan Afr Med J. 2019; 34:1–9.

[4] Shit S, Shifera A. Prevalence of cesarean section and associated factor among women who give birth in the last one year at Butajira General Hospital, Gurage Zone, SNNPR, Ethiopia, 2019. Int J Pregnancy Childbirth. 2020;6(1):16–21.

[5] Prah J, Kudom A, Afrifa A, Abdulai M, Sirikyi I, Abu E. Caesarean section in a primary health facility in Ghana: Clinical indications and. J Public Health Africa. 2017;8(639):98–102.

[6] Bi S, Zhang L, Chen J, Huang M, Huang L, Zeng S, et al. Maternal age at first cesarean delivery related to adverse pregnancy outcomes in a second cesarean delivery: a multicenter, historical, cross-sectional cohort study. BMC Pregnancy Childbirth. 2021;21(1):1–10.

[7] Seidu AA, Hagan JE, Agbemavi W, Ahinkorah BO, Nartey EB, Budu E, et al. Not just numbers: Beyond counting caesarean deliveries to understanding their determinants in Ghana using a population based cross-sectional study. BMC Pregnancy Childbirth. 2020;20(1):1–10.

[8] Ghana Maternal Health Survey 2017. Vol. 13, Ekp. 2017. 1576–1580 p.

[9] Adu-Bonsaffoh K, Tamma E, Seffah J. Preferred mode of childbirth among women attending antenatal clinic at a tertiary hospital in Ghana: a cross-sectional study. Afr Health Sci. 2022;22(2):480–8.

[10] FAO. 3 : Promote gender equality and empower women 4 : Reduce child mortality GOAL 5 : Improve maternal health Maternal mortality remains unacceptably high across much of the developing world . Fully achieving the MDG 5 target of reducing by three quarters the. Fact Sheet. 2015;5–6.

[11] WHO Statement on Caesarean Section Rates. World Heal Organ. 2015;8.

[12] WHO. WHO non-clinical recommendations unnecessary to reduce interventions caesarean sections. 2018.

[13] Hailegebreal S, Gilano G, Seboka BT, Ahmed MH, Simegn AE, Tesfa GA, et al. Prevalence and associated factors of caesarian section in Ethiopia: a multilevel analysis of the 2019 Ethiopia Mini Demographic Health Survey. BMC Pregnancy Childbirth [Internet]. 2021;21(1):1–9. Available from: https://doi.org/10.1186/s12884-021-04266-7.

[14] Adewuyi EO, Auta A, Khanal V, Tapshak SJ, Zhao Y. Cesarean delivery in Nigeria: Prevalence and associated factors •a population-based cross-sectional study. BMJ Open. 2019;9(6):1–12.

[15] Tarimo CS, Mahande MJ, Obure J. Prevalence and risk factors for caesarean delivery following labor induction at a tertiary hospital in North Tanzania: A retrospective cohort study (2000-2015). BMC Pregnancy Childbirth. 2020;20(1):1–8.

[16] Das P, Samad N, Sapkota A, Al-Banna H, A Rahman NA, Ahmad R, et al. Prevalence and Factors Associated with Caesarean Delivery in Nepal: Evidence from a Nationally Representative Sample. Cureus. 2021;13(12):11–2.

[17] Alhassan AR. Prevalence and socioeconomic predictive factors of cesarean section delivery in Ghana. 2022;190–5.

[18] Gunn JKL, Ehiri JE, Jacobs ET, Ernst KC, Pettygrove S, Center KE, et al. Prevalence of Caesarean sections in Enugu, southeast Nigeria: Analysis of data from the Healthy Beginning Initiative. PLoS One. 2017;12(3):1–14.

[19] Genc S, Emeklioglu CN, Cingillioglu B, Akturk E, Ozkan HT, Mihmanlı V. The effect of parity on obstetric and perinatal outcomes in pregnancies at the age of 40 and above: a retrospective study. Croat Med J. 2021 Apr;62(2):130–6.

[20] Jahromi BN, Husseini Z. Pregnancy Outcome at Maternal Age 40 and Older. Taiwan J Obstet Gynecol
[Internet]. 2008;47(3):318–21. Available from: https://www.sciencedirect.com/science/article/pii/S102845590860131X.

[21] Manyeh AK, Amu A, Akpakli DE, Williams J, Gyapong M. Socioeconomic and demographic factors associated with caesarean section delivery in Southern Ghana: evidence from INDEPTH Network member site. 2018;(November):1–9.

[22] Ahmed MS, Islam M, Jahan I, Shaon IF. Multilevel analysis to identify the factors associated with caesarean section in Bangladesh: evidence from a nationally representative survey. Int Health. 2022;1–7.

[23] Taye MG, Nega F, Belay MH, Kibret S, Fentie Y, Addis WD, et al. Prevalence and factors associated with caesarean section in a comprehensive specialized hospital of Ethiopia: A cross-sectional study; 2020. Ann Med Surg [Internet]. 2021;67(May):102520. Available from: https://doi.org/10.1016/j.amsu.2021.102520.

[24] Sengoma JPS, Krantz G, Nzayirambaho M, Munyanshongore C, Edvardsson K, Mogren I. Prevalence of pregnancy-related complications and course of labour of surviving women who gave birth in selected health facilities in Rwanda: A health facility-based, cross-sectional study. BMJ Open. 2017;7(7).

[25] Martinelli KG. The role of parity in the mode of delivery in advanced maternal age women. 21(1):65–75.

[26] Patel RR, Peters TJ, Murphy DJ, Team S. Prenatal risk factors for Caesarean section. Analyses of the ALSPAC cohort of 12 944 women in England. 2005;(January):353–67.

[27] Lin L, Lu C, Chen W, Li C, Guo VY. Parity and the risks of adverse birth outcomes: a retrospective study among Chinese. 2021;1–11.