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Prevalence, causes, and complications of cesarean delivery in Iran: A systematic review and metaanalysis
Rafiei, Mohammad; Naz, Marzieh Saei Ghare; Akbari, Malihe; Kiani, Faezeh; Sayehmiri, Fatemeh; Sayehmiri, Koroush & Vafaee, Reza
Abstract
Background: Uncontrolled increase of C-section is one of the major problems in
Iranian health system, such that C-section is the most common surgical procedure in
the entire country’s hospitals in Obstetrics and Gynecology sections. A variety of
complications also come along with cesarean.
Objective: The aim of this study was to evaluate the prevalence, causes, and
complications of cesarean in Iran.
Materials and Methods: forty-one articles were considered with respect to certain
criteria and were included in a systematic review to perform a meta-analysis study.
The systematic review’s search was conducted on SID, Iranmedx, Magiran, Medlib,
PubMed, and Science Direct databases published between1999-2016. The weight of
each included study was calculated according to its sample size and the reported
prevalence of binomial distribution. A random-effects model using R and STATA
(Version 11.2) software was utilized for analyzing data
Results: The total number of the sample was 197514 pregnant women with a mean
age of 26.72 yr. The prevalence of cesarean in Iran was estimated at 48%. The main
reasons for the prevalence of cesarean in this study were mothers’ higher education,
previous cesarean, and doctor recommendation. The most frequent complication in
women undergoing cesarean was the muscular pain, and the most common fetal
complications in newborns by caesarean delivery was transient tachypnea.
Conclusion: The prevalence of C-section in Iran is much higher than what WHO
recommends. It is essential, to decrease such a phenomenon, making the mothers
aware of the risks of cesarean delivery, and establishing counselling sessions as well
to eliminate the mothers’ fear of vaginal delivery.
Keywords
Cesarean; Iran; Prevalence; Meta-analysis.
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