Peer-reviewed article
Evaluation of Cesarean Delivery Rates across Ontario from 2012 to 2019 Using the Modified Robson Classification System: A Population-Based Study.
Dunn SI, Guo Y, Dimanlig-Cruz S, Murphy MSQ, Scremin Souza SC et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This is a population-based study of cesarean delivery rates in Ontario, Canada from 2012 to 2019. It describes trends in surgical delivery procedures and identifies the most common medical reasons for cesarean delivery using a classification system. The study does not evaluate interventions to improve child well-being or health outcomes.
Key points
- 952,567 pregnancies were included in the analysis over 7 years
- Overall cesarean delivery rate showed a slight increase over the study period
- Previous cesarean delivery was the most common indication, followed by fetal surveillance concerns and malposition
Limitations
This study describes delivery rates and procedures but does not measure child health outcomes or well-being. It does not evaluate any intervention designed to improve children's health or development.
Abstract
Objectives This study aimed to describe the trends in cesarean delivery (CD) rates in Ontario using the modified Robson classification system, and identify the most common indications for CD. Methods We conducted a population-based retrospective cross-sectional study using data from the Better Outcomes Registry & Network, a comprehensive maternal-child registry in Ontario. The analysis included all pregnant persons who delivered a live- or stillborn infant weighing ≥500 g at ≥200 weeks gestation between April 1, 2012 and March 31, 2019. Results A total of 952 567 pregnant persons gave birth in Ontario, Canada, during the study period. Our findings demonstrated a slight increase in the overall CD rate over 7 fiscal years from 2012-2013 to 2018-2019. Robson group 5 (term, singleton, cephalic pregnancy with previous CD), groups 1 and 2 (nulliparous, term, singleton, cephalic pregnancy and no labour, induced labour, or spontaneous labour), and group 6 (nulliparous pregnancy with breech presentation) made the largest contributions to the overall CD rate over the study period. The top 5 primary indications for CD across all years included previous CD, atypical or abnormal fetal surveillance, malposition/malpresentation, non-progressive first stage of labour, and non-progressive second stage of labour. Conclusions The results enhance our understanding of the key drivers of CD rates. These findings will help to inform practice improvement, support policy change, and identify areas where future research is needed.