RISK OF NEONATAL HOSPITALIZATION ASSOCIATED TO DELIVERY BY CESAREAN SECTION IN A HIGH COMPLEXITY CLINIC IN BOGOTÁ, COLOMBIA, 2018.

Abstract

Objective: To evaluate the association between cesarean delivery and hospitalization of the newborn and describe the indications for cesarean according to Robson's groups in the obstetrics service of a highly complex general institution.

Methods: Cross-sectional study. All births occurred between March and July 2018 in a high complexity general teaching hospital in Bogotá, Colombia were included, by consecutive sampling up to a sample size of 1040 pregnant women. The frequency of caesarean section, indications, neonatal outcomes for each Robson group, and the risk of neonatal hospitalization are described using the crude and adjusted odds ratio (OR) using multivariate analysis.

Results: 1,493 births were included, of which 539 (36.3 %) were by cesarean section. Women with a history of uterine scar scheduled for elective caesarean section and those hospitalized for induction provide the majority of caesarean sections. The main indications for cesarean section were suspicion of unsatisfactory fetal status and prolongued labor. Adjusted for birth weight, caesarean section increased the overall risk of neonatal hospitalization (adjusted OR [aOR] = 2,2; IC 99 %: 1,3-3,7).

Conclusions: There are groups of Robson susceptible of intervention to decrease the rate of caesarean sections due to the suspicion of unsatisfactory fetal status and prolongation of labor. An association was found between cesarean delivery and subsequent neonatal hospitalization. Randomized controlled studies are required to determine the benefit of the strategies to reduce cesarean section rates and evaluate the association found.