Risk Ratio Differences in the Exposure to Caesarean Section in the Central Area of the Western Highlands of Yemen

摘要

Compared to vaginal deliveries, caesarean section (C-section) is a major surgery that could be associated with higher risks of maternal and infant mortality and morbidity. In Yemen, some recent reports indicated overuses of C-section. This was a cross-sectional study aimed to assess the risk ratio difference in C-section exposure between Yemeni mothers according to their demographic variables. A total of 400 participants of reproductive age visiting health centers for obstetric care in the central area of the western highlands of Yemen were randomly interviewed using a pretested questionnaire. The results found that the prevalence of C-section exposure among the study participants was 22%. Mothers' demographic variables showed significant differences in the risk ratio of C-section exposure. Among these variables, large differences in the risk ratio of C-section exposure were estimated between urban versus rural (RR = 3.9, ER = 2.9, P □ 0.001) and literate versus illiterate mothers (RR = 3.8, ER = 2.8, P □ 0.001). Relatively moderate differences were revealed by parity and maternal age variables (RR = 2.7; ER = 1.7; P □ 0.001, RR = 2.6; ER = 1.6; P □ 0.001, respectively). Age at marriage, employment status, and visiting health services practice, however, were associated with low differences in the C-section exposure. To strengthen the mother and infant health programs in Yemen, maternal variables including place of residence and educational status should be considered as predictors for either an unnecessary or additionally needed C-section.