Obstet Gynecol Sci.  2020 Jul;63(4):440-447. 10.5468/ogs.19212.

Secular trends in cesarean sections and risk factors in South Korea (2006–2015)

Affiliations
  • 1Department of Obstetrics and Gynecology, Korea University College of Medicine, Seoul, Korea
  • 2Korea University Guro Hospital Smart Healthcare Center, Seoul, Korea

Abstract


Objective
This study aimed to investigate trends in the rate of cesarean sections (CSs) in South Korea from 2006 to 2015 and identify the risk factors associated with these changes.
Methods
Using the National Health Insurance Corporation dataset, all women who gave birth between 2006 and 2015 were included in the study. We investigated 1) the mode of delivery, 2) the complication rates during pregnancy (i.e., preeclampsia and placenta previa), and 3) pre-pregnancy factors (body mass index, hypertension [HTN], diabetes mellitus [DM], and other pre-existing medical conditions), and their trends during the study period.
Results
Over 10 years, the rate of CS increased from 36.3% in 2006 to 40.6% in 2015 (P<0.01). The rate of CS increased in primiparous women, women with multiple pregnancy, and women with preeclampsia. Maternal age and the incidence of placenta previa also increased. In contrast, the rate of vacuum deliveries and vaginal birth after CS decreased during the study period. The rate of women with pre-pregnancy obesity and DM increased, but the rate of women with pre-pregnancy HTN decreased.
Conclusion
The rate of CS in South Korea increased from 2006 to 2015. This trend may reflect changes in the rate of different risk factors. Identifying the causes of the increasing CS trend observed in this study will allow clinicians to monitor these factors and possibly reduce the rate of CS.

Keyword

Cesarean section; Trends; Risk factors

Figure

  • Fig. 1. Secular trends in the cesarean section rate between 2006 and 2015.


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