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Archives of Public Health
Published in: Archives of Public Health 1/2020

Open Access 01-12-2020 | Sectio Ceasarea | Systematic review

Prevalence, indications and neonatal complications of caesarean deliveries in Cameroon: a systematic review and meta-analysis

Authors: Tsi Njim, Bayee Swiri Tanyitiku, Clarence Mbanga

Published in: Archives of Public Health | Issue 1/2020

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Abstract

Background

The trend of increasing caesarean deliveries in developed countries over the past three decades is now being observed in sub-Saharan African. This rise might be associated with an increase in the complications that could arise from this surgical intervention. We therefore sought to assess the prevalence, indications and complications of caesarean deliveries in Cameroon.

Methods

We systematically searched online databases: Medline; Global Health and the CINAHL from 01st January 1966 to 25th July 2019. We reviewed published cohort studies, retrospective register analysis and cross-sectional studies that described cohorts of pregnant women presenting at delivery facilities in Cameroon; and included those that had an estimate of the proportion of women who delivered by caesarean sections.

Results

There were 126 articles initially identified by the search and 88 articles were retained after removal of duplicates. After screening of the titles and abstracts, and full text review, we identified 16 articles describing 22 cohorts of women presenting for delivery in health facilities in Cameroon. The overall estimate for the prevalence of caesarean deliveries was 9.9% (95% CI: 7.4, 12.8%, I2 = 99.68%, χ2 = 315.9, p < 0.001). The prevalence of caesarean deliveries increased progressively from 3.4% (95% CI: 2.2, 4.8%) before the year 2000, to 9.8% (95% CI: 7.4, 12.8%) between 2000 and 2009 and 14.7% (95% CI: 8.8, 21.7%) from 2010 to 2019. The three commonest indications for caesarean deliveries were: cephalopelvic disproportion (27.5%; 95% CI: 17.5, 38.7%); previous caesarean deliveries (13.2%; 95% CI: 7.4, 20.3%) and foetal distress (11.2%; 95% CI: 4.8, 19.5%). Neonates who were born by caesarean delivery were more likely to have neonatal asphyxia when compared with neonates born from vaginal deliveries (OR: 6.5; 95% CI: 2.5, 16.5).

Conclusion

The rates of caesarean deliveries in Cameroon falls just within the recommended 10–15% range proposed by the World Health Organisation but have however been increasing progressively in the past decades. There is a strong need to assess the various indications of caesarean deliveries in Cameroon in order to curb its associated complications.
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Literature
1.
WHO HRP. WHO statement on caesarean section rates: every effort should be made to provide caesarean sections to women in need, rather than striving to achieve a specific rate; 2015.
2.
Guzman E, Ludmir J, DeFrancesco M. High cesarean section rates in Latin America, a reflection of a different approach to labor? Open J Obstet Gynecol. 2015;5:433–5.CrossRef
3.
Njim T, Choukem SP, Mbu R. Cesarean sections in a secondary level care hospital of Cameroon: an analysis of their six-year trends and adverse neonatal outcomes. BMC Res Notes. 2017;10(1):430.PubMedPubMedCentralCrossRef
4.
Chalmers B. WHO appropriate technology for birth revisited. Br J Obstet Gynaecol. 1992;99(9):709–10.PubMedCrossRef
5.
Appropriate technology following birth. Lancet. 1986;2(8520):1387–8.
6.
Betran AP, Torloni MR, Zhang J, Ye J, Mikolajczyk R, Deneux-Tharaux C, et al. What is the optimal rate of caesarean section at population level? A systematic review of ecologic studies. Reprod Health. 2015;12:57.PubMedPubMedCentralCrossRef
7.
Hannah ME, Hannah WJ, Hewson SA, Hodnett ED, Saigal S, Willan AR. Planned caesarean section versus planned vaginal birth for breech presentation at term: a randomised multicentre trial. Term Breech Trial Collaborative Group. Lancet. 2000;356(9239):1375–83.CrossRefPubMed
8.
Ye J, Betran AP, Guerrero Vela M, Souza JP, Zhang J. Searching for the optimal rate of medically necessary cesarean delivery. Birth. 2014;41(3):237–44.PubMedCrossRef
9.
Althabe F, Sosa C, Belizan JM, Gibbons L, Jacquerioz F, Bergel E. Cesarean section rates and maternal and neonatal mortality in low-, medium-, and high-income countries: an ecological study. Birth. 2006;33(4):270–7.PubMedCrossRef
10.
Keag OE, Norman JE, Stock SJ. Long-term risks and benefits associated with cesarean delivery for mother, baby, and subsequent pregnancies: systematic review and meta-analysis. PLoS Med. 2018;15(1):e1002494.PubMedPubMedCentralCrossRef
11.
Prediger B, Polus S, Mathes T, Buhn S, Louwen F, Neugebauer EAM, et al. (Update of a) systematic review on the impact of elective early term (< 39th gestational week) caesarean sections on maternal and neonatal health - a protocol. Syst Rev. 2018;7(1):119.PubMedPubMedCentralCrossRef
12.
Betran AP, Merialdi M, Lauer JA, Bing-Shun W, Thomas J, Van Look P, et al. Rates of caesarean section: analysis of global, regional and national estimates. Paediatr Perinat Epidemiol. 2007;21(2):98–113.PubMedCrossRef
13.
McCourt C, Weaver J, Statham H, Beake S, Gamble J, Creedy DK. Elective cesarean section and decision making: a critical review of the literature. Birth. 2007;34(1):65–79.PubMedCrossRef
14.
Geidam AD, Audu BM, Kawuwa BM, Obed JY. Rising trend and indications of caesarean section at the university of Maiduguri teaching hospital, Nigeria. Ann Afr Med. 2009;8(2):127–32.PubMedCrossRef
15.
Lumbiganon P, Laopaiboon M, Gulmezoglu AM, Souza JP, Taneepanichskul S, Ruyan P, et al. Method of delivery and pregnancy outcomes in Asia: the WHO global survey on maternal and perinatal health 2007-08. Lancet. 2010;375(9713):490–9.PubMedCrossRef
16.
Villar J, Carroli G, Zavaleta N, Donner A, Wojdyla D, Faundes A, et al. Maternal and neonatal individual risks and benefits associated with caesarean delivery: multicentre prospective study. BMJ. 2007;335(7628):1025.PubMedPubMedCentralCrossRef
17.
Souza JP, Gulmezoglu A, Lumbiganon P, Laopaiboon M, Carroli G, Fawole B, et al. Caesarean section without medical indications is associated with an increased risk of adverse short-term maternal outcomes: the 2004-2008 WHO global survey on maternal and perinatal health. BMC Med. 2010;8:71.PubMedPubMedCentralCrossRef
18.
19.
20.
21.
Mbassi SM, Mbu R, Bouvier-Colle MH. Use of routinely collected data to assess maternal mortality in seven tertiary maternity centers in Cameroon. Int J Gynaecol Obstet. 2011;115(3):240–3.PubMedCrossRef
22.
Nana PN, Fomulu JN, Djenabou A, Mbu RE, Tonye R, Wandji JC, et al. Epidemio-clinical factors associated with caesarean section in two referral hospitals (public/faith-based), Far-North region, Cameroon. Clin Mother Child Health. 2011;8:Article ID C100602–Article ID C.
23.
Buekens P, Curtis S, Alayón S. Demographic and Health Surveys: caesarean section rates in sub-Saharan Africa. Br Med J. 2003;326(7381):136.CrossRef
24.
Agbor VN, Mbanga CM, Njim T. Adolescent deliveries in rural Cameroon: an 8-year trend, prevalence and adverse maternofoetal outcomes. Reprod Health. 2017;14(1):122.PubMedPubMedCentralCrossRef
25.
Ahounkeng NP, Mboudou ET, Adjoby CR, Rakotomalala NZ, Foumane P, Dohbit SJ, et al. Impact of excessive weight gain during pregnancy on maternal and fetal outcome at the Yaoundé Women's and Children's hospital (Cameroon). Medecine Et Sante Tropicales. 2014;24(1):63–7.PubMedCrossRef
26.
Doh AS. A clinical study of caesarean section at the university teaching hospital (C.H.U.) Yaounde (1982-1989). Cent Afr J Med. 1991;37(10):326–8.PubMed
27.
Fouelifack FY, Fouedjio JH, Fouogue JT, Sando Z, Fouelifa LD, Mbu RE. Associations of body mass index and gestational weight gain with term pregnancy outcomes in urban Cameroon: a retrospective cohort study in a tertiary hospital. BMC Research Notes. 2015;8:806.PubMedPubMedCentralCrossRef
28.
Fouelifack FY, Tameh TY, Mbong EN, Nana PN, Fouedjio JH, Fouogue JT, et al. Outcome of deliveries among adolescent girls at the Yaoundé central hospital. BMC Pregnancy Childbirth. 2014;14:102.PubMedPubMedCentralCrossRef
29.
Foumane P, Mve Koh V, Ze Minkande J, Njofang Ngantcha EA, Dohbit JS, Mboudou ET. Risk factors and prognosis of emergency cesarean delivery at the Yaoundé Women's and Children's hospital, Cameroon. Medecine Et Sante Tropicales. 2014;24(1):89–93.PubMedCrossRef
30.
Ngowa JDK, Ngassam A, Fouogue JT, Metogo J, Medou A, Kasia JM. Early maternal complications of caesarean section: Review of 460 cases in two university hospitals in Yaounde, Cameroon. / Complications maternelles précoces de la césarienne: à propos de 460 cas dans deux hôpitaux universitaires de yaoundé, Cameroun. Pan Afr Med J. 2015;21:265.PubMedPubMedCentral
31.
32.
Nkwabong E, Nana PN, Mbu R, Takang W, Ekono MR, Kouam L. Indications and maternofetal outcome of instrumental deliveries at the university teaching Hospital of Yaounde, Cameroon. Tropical Doctor. 2011;41(1):5–7.PubMedCrossRef
33.
Tamambang RF, Njim T, Njie AE, Mbuagbaw L, Mafuta A, Tchana M, et al. Adolescent deliveries in urban Cameroon: a retrospective analysis of the prevalence, 6-year trend and adverse outcomes. BMC Res Notes. 2018;11(1):469.PubMedPubMedCentralCrossRef
34.
Tanyi TJ, Atashili J, Fon PN, Robert T, Paul KN. Caesarean delivery in the Limbé and the Buea regional hospitals, Cameroon: frequency, indications and outcomes. Pan Afr Med J. 2016;24:227.PubMedPubMedCentralCrossRef
35.
Tebeu PM, Ngassa P, Mboudou E, Kongnyuy E, Binam F, Abena MTO. Neonatal survival following cesarean delivery in northern Cameroon. Int J Gynaecol Obstet. 2008;103(3):259–60.PubMedCrossRef
36.
Moges A, Ademe BW, Akessa GM. Prevalence and Outcome of Caesarean Section in Attat Hospital, Gurage Zone, SNNPR, Ethiopia. Arch Med. 2015;7(4):8.
37.
Elzahaf RA, Ajroud S. Prevalence and indication of cesarean section in Al-Wahda hospital, Derna, Libya: a retrospective study. Libyan J Med Sci. 2018;2(2):68–72.CrossRef
38.
Yaya S, Uthman OA, Amouzou A, Bishwajit G. Disparities in caesarean section prevalence and determinants across sub-Saharan Africa countries. Glob Health Res Policy. 2018;3:19.PubMedPubMedCentralCrossRef
39.
Najmi RS, Rehan N. Prevalence and determinants of caesarean section in a teaching hospital of Pakistan. J Obstet Gynaecol. 2009;20(5):479–83.
40.
Rafiei M, Saei Ghare M, Akbari M, Kiani F, Sayehmiri F, Sayehmiri K, et al. Prevalence, causes, and complications of cesarean delivery in Iran: a systematic review and meta-analysis. Int J Reprod Biomed (Yazd). 2018;16(4):221–34.CrossRef
41.
Singh P, Hashmi G, Swain PK. High prevalence of cesarean section births in private sector health facilities- analysis of district level household survey-4 (DLHS-4) of India. BMC Public Health. 2018;18(1):613.PubMedPubMedCentralCrossRef
42.
Barros FC, Rabello Neto DL, Villar J, Kennedy SH, Silveira MF, Diaz-Rossello JL, et al. Caesarean sections and the prevalence of preterm and early-term births in Brazil: secondary analyses of national birth registration. BMJ Open. 2018;8(8):e021538.PubMedPubMedCentralCrossRef
43.
44.
Benzouina S, Boubkraoui Mel M, Mrabet M, Chahid N, Kharbach A, El-Hassani A, et al. Fetal outcome in emergency versus elective cesarean sections at Souissi maternity hospital, Rabat, Morocco. Pan Afr Med J. 2016;23:197.PubMedPubMedCentralCrossRef
Metadata
Title
Prevalence, indications and neonatal complications of caesarean deliveries in Cameroon: a systematic review and meta-analysis
Authors
Tsi Njim
Bayee Swiri Tanyitiku
Clarence Mbanga
Publication date
01-12-2020
Publisher
BioMed Central
Published in
Archives of Public Health / Issue 1/2020
Electronic ISSN: 2049-3258
DOI
https://doi.org/10.1186/s13690-020-00430-1

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