Abstract
Introduction In Germany the rate of deliveries by cesarean section is continually increasing.
Many different reasons have been put forward to explain this trend. The aim of this
study was to examine how the C-section rate developed at the University Gynecology
Clinic Rostock, one of the biggest maternity hospitals and level I perinatal centers
in Germany, based on various maternal and neonatal parameters. The aim was also to
identify potential risk factors for C-sections.
Material and Method Various obstetric parameters were obtained from the birth cohort (2008 to 2014; n = 20 091)
of the University Gynecology Clinic Rostock. The data was used to calculate parameter-specific
C-section rates. Potential risk factors for C-section were identified by regression
analysis.
Results The C-section rate dropped from 26.24% to 23.57%. The rate of repeat C-sections also
declined. The mean age of the pregnant women increased. Nevertheless, the frequency
of cesarean sections in pregnant women aged more than 35 years declined. Rates of
being overweight or obese preconception increased. C-section rates increased as BMI
values preconception increased. There was a perceptible trend towards attempting the
vaginal delivery of children in breech presentation and of twins. The frequency of
depressed neonates after vaginal delivery and after C-section decreased. Rates for
mild and advanced acidosis increased after both C-sections and vaginal deliveries.
Previous C-section, older maternal age, overweight and obesity prior to conception,
breech presentation and multiple pregnancies all increased the risk of cesarean sections.
Conclusion This study showed that reducing the rates of C-sections without a deterioration in
neonatal outcomes can be achieved even in a large maternity hospital that cares for
many high-risk pregnancies.
Key words
cesarean section - neonatal outcome - breech presentation - twins
