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Mikolajczyk-et-al_2013_Regional variation in caesarean.PDF 418,48KB
WeightNameValue
1000 Titel
  • Regional variation in caesarean deliveries in Germany and its causes
1000 Autor/in
  1. Mikolajczyk, Rafael |
  2. Schmedt, Niklas |
  3. Zhang, Jun |
  4. Lindemann, Christina |
  5. Langner, Ingo |
  6. Garbe, Edeltraut |
1000 Erscheinungsjahr 2013
1000 LeibnizOpen
1000 Art der Datei
1000 Publikationstyp
  1. Artikel |
1000 Online veröffentlicht
  • 2013-05-01
1000 Erschienen in
1000 Quellenangabe
  • 13:99
1000 FRL-Sammlung
1000 Copyrightjahr
  • 2013
1000 Lizenz
1000 Verlagsversion
  • http://dx.doi.org/10.1186/1471-2393-13-99 |
  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3652783/ |
1000 Ergänzendes Material
  • https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/1471-2393-13-99#Declarations |
1000 Publikationsstatus
1000 Begutachtungsstatus
1000 Sprache der Publikation
1000 Abstract/Summary
  • BACKGROUND: Determinants of regional variation in caesarean sections can contribute explanations for the observed overall increasing trend of caesarean sections. We assessed which mechanism explains the higher rate of caesarean sections in the former West than East Germany: a more liberal use of caesarean sections in the case of relative indications or more common caesarean sections without indications. METHODS: We used a health insurance database from all regions of Germany with approximately 14 million insured individuals (about 17% of the total population in Germany). We selected women who gave birth in the years 2004 to 2006 and identified indications for caesarean section on the basis of hospital diagnoses in 30 days around birth. We classified pregnancies into three groups: those with strong indications for caesarean section (based on classification of absolute indications recommended by the Unmet Obstetrics Need network), those with moderate indications (other indications increasing the probability of caesarean section) and those with no indications. We investigated the percentage of caesarean sections among all births, presence of strong or moderate indications in all pregnancies, the probability of caesarean sections in the presence of indications and the fraction of caesarean sections attributable to strong, moderate and no indications. RESULTS: In total, 294,841 births from 2004–2006 were included in the analysis. In the former West Germany, 30% births occurred by caesarean section, while in the former East Germany the caesarean section rate was 22%. Proportions of pregnancies with strong and moderate indications for caesarean section were similar in both regions. For strong indications the probability of caesarean section was similar in East and West Germany, but the probability of caesarean section among women with moderate indications was substantially higher in the former West Germany. Caesarean sections were also more common among women with no indications in the former West (8%) than in the former East (4-5%). The higher probability of caesarean section in the case of strong or moderate indications in the former West than in the East explained 87% of the difference between section rates in these two regions, while caesarean sections without indications contributed to only 13% of the difference observed. CONCLUSIONS: The observed difference between caesarean section rates in the former East and West Germany was most likely due to different medical practice in handling relative indications.
1000 Sacherschließung
lokal Caesarean section
lokal Absolute and relative indications
lokal Time trends
lokal Regional differences
1000 Fachgruppe
  1. Medizin |
  2. Gesundheitswesen |
1000 Fächerklassifikation (DDC)
1000 Liste der Beteiligten
  1. http://orcid.org/0000-0003-1271-7204|https://frl.publisso.de/adhoc/creator/U2NobWVkdCwgTmlrbGFz|https://frl.publisso.de/adhoc/creator/WmhhbmcsIEp1bg==|https://frl.publisso.de/adhoc/creator/TGluZGVtYW5uLCBDaHJpc3RpbmE=|https://frl.publisso.de/adhoc/creator/TGFuZ25lciwgSW5nbw==|https://frl.publisso.de/adhoc/creator/R2FyYmUsIEVkZWx0cmF1dA==
1000 Label
1000 Förderer
  1. Bayer Pharma AG
1000 Fördernummer
  1. -
1000 Förderprogramm
  1. -
1000 Dateien
  1. Regional variation in caesarean deliveries in Germany and its causes
1000 Objektart article
1000 Beschrieben durch
1000 @id frl:6407392.rdf
1000 Erstellt am 2018-04-03T14:52:36.101+0200
1000 Erstellt von 266
1000 beschreibt frl:6407392
1000 Bearbeitet von 266
1000 Zuletzt bearbeitet Thu Jan 30 16:31:54 CET 2020
1000 Objekt bearb. Mon Apr 09 11:07:02 CEST 2018
1000 Vgl. frl:6407392
1000 Oai Id
  1. oai:frl.publisso.de:frl:6407392 |
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1000 Sichtbarkeit Daten public
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