High rates of caesarean delivery may harm mothers and newborns

EMBARGO: 00:01H (London time) Tuesday May 23, 2006. In North America the embargo lifts at 18:30H ET Monday May 22, 2006.

High rates of caesarean delivery in Latin America can be associated with a greater risk of maternal and newborn illness and death, report the authors of a paper published online today by The Lancet (Tuesday May 23, 2006).

Caesarean delivery rates are increasing worldwide. During 2005, Jose Villar (World Health Organization) and colleagues assessed the association between rates of caesarean delivery and maternal and newborn outcomes in hospitals in Latin America. 120 public, private, and social security hospitals from 24 geographic regions in eight countries in Latin America were randomly selected for inclusion in the study (91% of the population were served by these hospitals). The investigators analysed over 97 000 deliveries. They found that hospitals with high rates of caesarean delivery had higher rates of severe maternal illness, death, and antibiotic treatment post pregnancy, even after they adjusted for risk factors such as the characteristics of the women, referrals, and the type of hospital. They also found that rates of preterm delivery and newborn deaths rose with the increasing rates of caesarean delivery of between 10% and 20%.

Dr Villar states: "In conclusion, high rates of caesarean delivery do not necessarily indicate good quality care or services. Indeed institutions that deliver a lot of babies by caesarean should initiate a detailed and rigorous assessment of the factors related to their obstetric care and the perinatal outcomes achieved vis--vis the case mix of the population they serve; at present their services might cause iatrogenic harm."

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Contact: Dr Jos Villar, UNDP/UNFA/WHO/World Bank Special Programme of Research, Development and Research Training in Human Production, Department of Reproductive Health and Research, CH-1211 Geneva 27, Switzerland. T) 41 22 79 1 3327 villarj@who.int

Note to editors
Iatrogenic means doctor-related


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