Retrospective analysis of cesarean section rates in reproductive-aged women in the Kyrgyz Republic

Objective. To assess current cesarean section (CS) birth trends in pregnant women in the Kyrgyz Republic (KR) in order to develop activities of applied significance and to provide their scientific substantiation. Material and methods. This study used data from the annual reports of the Republican Medical Information Center, Ministry of Health of the KR, over 2005-2015. To estimate CS rates, the time series were analyzed in terms of absolute growth indicators, visibility index, growth rate, and 1% incremental value; the dynamic series was equalized calculating the moving average and using the interval coalescence method. CS delivery rates to births (100%) and M±m (per 1,000 births) were estimated. Maternal deaths per 100,000 live births were calculated. Perinatal mortality rates per 1,000 live and still births were determined. The investigators calculated correlation and determination coefficients, Student’s test and McNemar’s test to assess the shape, closeness, reliability of a correlation between CS rates and maternal and perinatal deaths. Results. The rate of CS in the KR over the past eleven years has steadily increased by 2.9 times (p < 0.001). There is an inverse, strong, and significant correlation between the increased cesarean birth rates and maternal and perinatal mortality. This period in Bishkek is marked by a 2.4-fold rise in CS rates (p < 0.001). In the KR, there was a significant (2-fold) percent increase in CS rates as compared to vaginal deliveries (p < 0.001). The CS/birth ratio ranks first in the self-sustained republican organizations of Bishkek. In the Naryn region during the analyzed period, the CS/birth ratio increased 4.4-fold (p < 0.001), which is 1.5 times higher than the republican values. Conclusion. The scientific evaluation of findings requires the rethinking of indications and the elaboration of CS rates to significantly decrease maternal and perinatal deaths in the country.

caesarean section, rate, retrospective study, Kyrgyz Republic