Hospital Discharge Data Best Explains Reason for Caesarean

Information on birth certificates about no-risk Caesareans misleading

TUESDAY, Dec. 23 (HealthDay News) -- Information taken from birth certificates alone indicates that more than half of Caesarean deliveries are performed among women with no indicated risk, but when hospital discharge data is used in combination with birth certificates the number drops to low single digits, according to a report published in the January issue of Obstetrics & Gynecology.

Emily B. Kahn, Ph.D., of the U.S. Centers for Disease Control and Prevention in Atlanta, and colleagues analyzed data on 565,767 singleton, vertex live births at 37 to 41 weeks' gestation, of whom 40,932 were born by Caesarean section with no risk recorded on the birth certificate, and 35,761 (87.4 percent) of whom were at risk according to the hospital discharge data.

The researchers found that there was very little correlation between the two data sources in terms of low-risk deliveries, and that birth certificate data pointed to 58.3 percent of Caesarean births without a stated risk, versus 3.9 percent when this data as used in conjunction with hospital discharge data.

"Using birth certificate information alone overestimated the proportion of women who had no-indicated-risk Caesarean deliveries in Georgia," the authors write. "Evidence of many indications for Caesarean delivery can be found only in the hospital discharge data. The construct of no indicated risk as determined from birth certificates should be interpreted with caution, and the use of linked data should be considered whenever possible."

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