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Rates of instrumental vaginal birth and cesarean and quality of maternal and newborn health care in private versus public facilities : Results of the IMAgiNE EURO study in 16 countries

Lazzerini, Marzia ; Valente, Emanuelle Pessa ; Covi, Benedetta ; Rozée, Virginie ; Costa, Raquel ; Otelea, Marina Ruxandra ; Abderhalden-Zellweger, Alessia ; Węgrzynowska, Maria ; Linden, Karolina LU orcid and Arendt, Maryse , et al. (2022) In International Journal of Gynecology & Obstetrics 159(S1). p.22-38
Abstract

OBJECTIVE: To explore the quality of maternal and newborn care (QMNC) during the COVID-19 pandemic by facility type among 16 European countries, comparing rates of instrumental vaginal birth and cesarean.

METHODS: Women who gave birth in the WHO European Region from March 1, 2020, to February 7, 2022, answered a validated online questionnaire. Rates of instrumental birth, instrumental vaginal birth, and cesarean, and a QMNC index were calculated for births in public versus private facilities.

RESULTS: Responses from 25 206 participants were analyzed. Women giving birth in private compared with public facilities reported significantly more frequent total cesarean (32.5% vs 19.0%; aOR 1.70; 95% CI 1.52-1.90), elective cesarean... (More)

OBJECTIVE: To explore the quality of maternal and newborn care (QMNC) during the COVID-19 pandemic by facility type among 16 European countries, comparing rates of instrumental vaginal birth and cesarean.

METHODS: Women who gave birth in the WHO European Region from March 1, 2020, to February 7, 2022, answered a validated online questionnaire. Rates of instrumental birth, instrumental vaginal birth, and cesarean, and a QMNC index were calculated for births in public versus private facilities.

RESULTS: Responses from 25 206 participants were analyzed. Women giving birth in private compared with public facilities reported significantly more frequent total cesarean (32.5% vs 19.0%; aOR 1.70; 95% CI 1.52-1.90), elective cesarean (17.3% vs 7.8%; aOR 1.90; 95% CI 1.65-2.19), and emergency cesarean before labor (7.4% vs 3.9%; aOR 1.39; 95% CI 1.14-1.70) (P < 0.001 for all comparisons), with analyses by country confirming these results. QMNC index results were heterogeneous across countries and regions in the same country and were largely affected by geographical distribution of regions rather than by type of facility alone.

CONCLUSION: The study confirms that births in private facilities have higher odds of cesarean. It also suggests that QMNC should be closely monitored in all facilities to achieve high-quality care, independent of facility type or geographical distribution.

GOV IDENTIFIER: NCT04847336.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Female, Humans, Infant, Newborn, Pregnancy, Cesarean Section, COVID-19/epidemiology, Infant Health, Pandemics, Public Facilities
in
International Journal of Gynecology & Obstetrics
volume
159
issue
S1
pages
22 - 38
publisher
Wiley-Blackwell
external identifiers
  • pmid:36530007
  • scopus:85144411279
ISSN
1879-3479
DOI
10.1002/ijgo.14458
language
English
LU publication?
yes
additional info
© 2022 The Authors. International Journal of Gynecology & Obstetrics published by John Wiley & Sons Ltd on behalf of International Federation of Gynecology and Obstetrics.
id
1b890c5c-6d12-409d-9074-2bcd220c3fb6
date added to LUP
2022-12-24 10:04:23
date last changed
2024-06-14 17:41:00
@article{1b890c5c-6d12-409d-9074-2bcd220c3fb6,
  abstract     = {{<p>OBJECTIVE: To explore the quality of maternal and newborn care (QMNC) during the COVID-19 pandemic by facility type among 16 European countries, comparing rates of instrumental vaginal birth and cesarean.</p><p>METHODS: Women who gave birth in the WHO European Region from March 1, 2020, to February 7, 2022, answered a validated online questionnaire. Rates of instrumental birth, instrumental vaginal birth, and cesarean, and a QMNC index were calculated for births in public versus private facilities.</p><p>RESULTS: Responses from 25 206 participants were analyzed. Women giving birth in private compared with public facilities reported significantly more frequent total cesarean (32.5% vs 19.0%; aOR 1.70; 95% CI 1.52-1.90), elective cesarean (17.3% vs 7.8%; aOR 1.90; 95% CI 1.65-2.19), and emergency cesarean before labor (7.4% vs 3.9%; aOR 1.39; 95% CI 1.14-1.70) (P &lt; 0.001 for all comparisons), with analyses by country confirming these results. QMNC index results were heterogeneous across countries and regions in the same country and were largely affected by geographical distribution of regions rather than by type of facility alone.</p><p>CONCLUSION: The study confirms that births in private facilities have higher odds of cesarean. It also suggests that QMNC should be closely monitored in all facilities to achieve high-quality care, independent of facility type or geographical distribution.</p><p>GOV IDENTIFIER: NCT04847336.</p>}},
  author       = {{Lazzerini, Marzia and Valente, Emanuelle Pessa and Covi, Benedetta and Rozée, Virginie and Costa, Raquel and Otelea, Marina Ruxandra and Abderhalden-Zellweger, Alessia and Węgrzynowska, Maria and Linden, Karolina and Arendt, Maryse and Brigidi, Serena and Miani, Céline and Pumpure, Elizabete and Radetic, Jelena and Drandic, Daniela and Cerimagic, Amira and Nedberg, Ingvild Hersoug and Liepinaitienė, Alina and Rodrigues, Carina and de Labrusse, Claire and Baranowska, Barbara and Zaigham, Mehreen and Castañeda, Lara Martín and Batram-Zantvoort, Stephanie and Jakovicka, Dārta and Ruzicic, Jovana and Juciūtė, Simona and Santos, Teresa and Gemperle, Michael and Tataj-Puzyna, Urszula and Elden, Helen and Mizgaitienė, Marija and Lincetto, Ornella and Sacks, Emma and Mariani, Ilaria}},
  issn         = {{1879-3479}},
  keywords     = {{Female; Humans; Infant, Newborn; Pregnancy; Cesarean Section; COVID-19/epidemiology; Infant Health; Pandemics; Public Facilities}},
  language     = {{eng}},
  number       = {{S1}},
  pages        = {{22--38}},
  publisher    = {{Wiley-Blackwell}},
  series       = {{International Journal of Gynecology & Obstetrics}},
  title        = {{Rates of instrumental vaginal birth and cesarean and quality of maternal and newborn health care in private versus public facilities : Results of the IMAgiNE EURO study in 16 countries}},
  url          = {{http://dx.doi.org/10.1002/ijgo.14458}},
  doi          = {{10.1002/ijgo.14458}},
  volume       = {{159}},
  year         = {{2022}},
}