Osong Public Health Res Perspect.  2018 Apr;9(2):86-92. 10.24171/j.phrp.2018.9.2.08.

Factors Associated with Cesarean Section in Tehran, Iran using Multilevel Logistic Regression Model

• Amini P
• Mohammadi
• Omani-Samani R
• Almasi-Hashiani A
• Maroufizadeh S

• KMID: 2413261
• DOI: http://doi.org/10.24171/j.phrp.2018.9.2.08

Abstract

OBJECTIVES
Over the past few decades, the prevalence of cesarean sections (CS) have risen dramatically worldwide, particularly in Iran. The aim of this study was to determine the prevalence of CS in Tehran, and to examine the associated risk factors.
METHODS
A cross-sectional study of 4,308 pregnant women with singleton live-births in Tehran, Iran, between July 6-21, 2015 was performed. Multilevel logistic regression analysis was performed using demographic and obstetrical variables at the first level, and hospitals as a variable at the second level.
RESULTS
The incidence of CS was 72.0%. Multivariate analysis showed a significant relationship between CS and the mother's age, socioeconomic status, body mass index, parity, type of pregnancy, preeclampsia, infant height, and baby's head circumference. The intra-class correlation using the second level variable, the hospital was 0.292, indicating approximately 29.2% of the total variation in the response variable accounted for by the hospital.
CONCLUSION
The incidence of CS was substantially higher than other countries. Therefore, educational and psychological interventions are necessary to reduce CS rates amongst pregnant Iranian women.

Keyword

cesarean section; Iran; logistic models; pregnancy

MeSH Terms

Body Mass Index
Cesarean Section*
Cross-Sectional Studies
Female
Head
Humans
Incidence
Infant
Iran*
Logistic Models*
Multivariate Analysis
Parity
Pre-Eclampsia
Pregnancy
Pregnant Women
Prevalence
Risk Factors
Social Class