Risk factors for cesarean section in women of urban Puducherry, India: A matched case–control study

Cesarean section (CS) is generally performed either to ensure maternal and child safety when vaginal delivery is not possible. The WHO has indicated that CS rates of more than 10% are considered overutilization. Increased CS rates can cause an increase in postpartum antibiotic treatment and longer hospital stay. In this research, we conducted a matched case–control study, including all women who gave birth through CS and resided in the study area over a 3-year period before the survey as cases and similar age- and year-matched women who had normal vaginal delivery during the same period as controls. The data were collected using a semi-structured pro forma through personal interviews and verified with discharge cards. We obtained a sample of 140 women (70 matched cases and controls) as study participants. Our results show that unadjusted analysis revealed socioeconomic status, history of gestational diabetes mellitus, previous lower segment CS (LSCS), and malpresentation emerged as risk factors, whereas in the adjusted analysis, we observed that previous LSCS (aOR 45.4 [4.3 – 483.6]), malpresentation (aOR 11.0 [1.6 – 73.8]), and belonging to middle (aOR 3.3 [1.0 – 10.8]) and upper class (aOR 23.55 [CI: 1.2 – 463.8]) remained as independent risk factors. Our study identified independent risk factors for CS that needs to be tackled for bringing down the CS rates.