RESUMEN
Background: Although cesarean delivery on maternal request (CDMR) has been associated with an increase in the frequency of cesarean sections (CSs), there is a lack of studies reporting the frequency of CDMR in Saudi Arabia. This study was conducted to estimate the prevalence of and the motives for CDMR and identify its associated factors. Methods: This cross-sectional study was conducted between March and June 2017 on 364 pregnant women who planned a CS at King Abdulaziz Medical City in Riyadh. The characteristics of the women and their motives for undergoing a CS for the current pregnancy term were collected. Results: The prevalence of CDMR was found to be 13.7% (50/364) [95% confidence interval (CI): 10.370%-17.706%]. Older maternal age ( ≥ 40 years) [adjusted odds ratio (aOR) = 3.9; p = 0.019], family history of CS (aOR = 2.9; p = 0.038), non-Saudi nationality (aOR = 5.0; p = 0.050), and receiving education or medical information about the possibility of delivering by CS (aOR = 13.7; p = 0.030) were significantly associated with a higher prevalence of CDMR. As the number of previous CSs increased by one (aOR = 0.6; p = 0.011), the odds of CDMR decreased by 40%. The most common motives for demanding a CS in the absence of medical indications were avoiding labor or possible complications from vaginal birth (60%) and fear of pain on vaginal delivery (46%). Conclusions: A high prevalence of CDMR was documented at King Abdulaziz Medical City, especially among women of older maternal age, having a family history of CS, of non-Saudi nationality, and who received education or medical information about the possibility of delivering by CS. Counseling programs might be helpful for pregnant women who fear pain in vaginal delivery or have had a previous traumatic birth experience.
RESUMEN
OBJECTIVES: To study the associated factors for cesarean section (C-section) in a sample of pregnant women and to estimate its frequency at King Abdulaziz Medical City in Riyadh, Kingdom of Saudi Arabia (KAMC-R). Methods: We studied 364 pregnant women who attended the Gynecology and Obstetrics Clinic at KAMC-R between March and June 2017. Results: Our 3-month study had higher rates of C-sections: women with older maternal age; (adjusted risk ratio [aRR]=1.08, p=0.001), lack of education (aRR=1.39, p=0.022), no personal history of vaginal delivery (aRR=1.85, p=0.001), undergoing C-section due to medical indications (aRR=2.28, p=0.001), and willing to repeat a C-section in the absence of medical indications (aRR=1.49, p=0.006). Cesarean section occurred in 27% of the total deliveries in 2016. Conclusion: Cesarean section are very frequent and prevalent in our center, and may be increasing. The frequency of C-sections was significantly higher for women of older maternal age, little education, no personal history of vaginal delivery, undergoing C-sections due to medical indications, and those willing to repeat a C-section in the absence of medical indications.