Trends of caesarean delivery from 2008 to 2017, Mexico/Evolution des accouchements par cesarienne entre 2008 et 2017 au Mexique/Tendencias de los partos por cesarea de 2008 a 2017, Mexico

• Published in: Bulletin of the World Health Organization 2019-07, Vol.97 (7), p.502
• Main Authors: Cervantes-Trejo, Arturo, Barrero-Castillero, Alejandra, Santos, Jose Manuel, de la Rosa-Rabago, Alberto, Lipsitz, Stuart R, Basavilvazo-Rodriguez, Maria Antonia, Shah, Neel, Molina, Rose L, Uribe-Leitz, Tarsicio
• Format: Article
• Language: English
• Subjects: Cesarean section; Infant mortality; Medical research; Prevention
• ISSN: 0042-9686
• DOI: 10.2471/BLT.18.224303

Caesarean delivery rates in Mexico are among the highest in the world. Given heightened public and professional awareness of this problem and the updated 2014 national guidelines to reduce the frequency of caesarean delivery, we analysed trends in caesarean delivery by type of facility in Mexico from 2008 to 2017. We obtained birth-certificate data from the Mexican General Directorate for Health Information and grouped the total number of vaginal and caesarean deliveries into five categories of facility: health- ministry hospitals; private hospitals; government employment-based insurance hospitals; military hospitals; and other facilities. Delivery rates were calculated for each category nationally and for each state. On average, 2 114 630 (95% confidence interval, CI: 2 061 487-2 167 773) live births occurred nationally each year between 2008 and 2017. Of these births, 53.5% (1 130 570; 95% CI: 1 108 068-1 153 072) were vaginal deliveries, and 45.3% (957 105; 95% CI: 922 936-991 274) were caesarean deliveries, with little variation over time. During the study period, the number of live births increased by 4.4% (from 1 978 380 to 2 064 507). The vaginal delivery rate decreased from 54.8% (1 083 331/1 978 380) to 52.9% (1091 958/2 064 507), giving a relative percentage decrease in the rate of 3.5%. The caesarean delivery rate increased from 43.9% (869 018/1 978 380) to 45.5% (940 206/2 064 507), giving a relative percentage increase in the rate of 3.7%. The biggest change in delivery rates was in private-sector hospitals. Since 2014, rates of caesarean delivery have fallen slightly in all sectors, but they remain high at 45.5%. Policies with appropriate interventions are needed to reduce the caesarean delivery rate in Mexico, particularly in private-sector hospitals. Les taux d'accouchements par cesarienne au Mexique sont parmi les plus eleves au monde. Au vu de la sensibilisation accrue de la population et des professionnels a ce probleme et de la mise a jour des directives nationales de 2014 visant a diminuer la frequence des accouchements par cesarienne, nous avons analyse l'evolution des accouchements par cesarienne selon le type d'etablissement entre 2008 et 2017 au Mexique. Nous avons obtenu des donnees issues d'actes de naissance aupres de la Direction generale mexicaine des informations sur la sante et regroupe le nombre total d'accouchements par voie basse et par cesarienne en cinq categories d'etablissement: hopitaux relevant du ministere de la Sa