{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,27]],"date-time":"2026-01-27T13:41:26Z","timestamp":1769521286621,"version":"3.49.0"},"reference-count":18,"publisher":"Federa\u00e7\u00e3o das Associa\u00e7\u00f5es de Ginecologia e Obstetr\u00edcia","issue":"07","license":[{"start":{"date-parts":[[2020,7,31]],"date-time":"2020-07-31T00:00:00Z","timestamp":1596153600000},"content-version":"vor","delay-in-days":30,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Rev Bras Ginecol Obstet"],"published-print":{"date-parts":[[2020,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Objective\u2003To investigate the patterns of hospital births in the state of Rio de Janeiro (RJ), Brazil, between 2015 and 2016; considering the classification of obstetric characteristics proposed by Robson and the prenatal care index proposed by Kotelchuck.<\/jats:p><jats:p>\n          Methods\u2003Data obtained from the Information System on Live Births of the Informatics Department of the Brazilian Unified Health System (SINASC\/DATASUS, in the Portuguese acronym) databases were used to group pregnant women relatively to the Robson classification. A descriptive analysis was performed for each Robson group, considering the variables: maternal age, marital status, schooling, parity, Kotelchuck prenatal adequacy index and gestational age. A logistic model estimated odds ratios (ORs) for cesarean sections (C-sections), considering the aforementioned variables.<\/jats:p><jats:p>\n          Results\u2003Out of the 456,089 live births in Rio de Janeiro state between 2015 and 2016, 391,961 records were retained, 60.3% of which were C-sections. Most pregnant women (58.6%) were classified in groups 5, 2 or 3. The percentage of C-sections in the Robson groups 1, 2, 3, 4, 5 and 8 was much higher than expected. Prenatal care proved to be inadequate for women who subsequently had a vaginal delivery, had an unfavorable family structure and a lower socioeconomic status (mothers without partners and with lower schooling), compared with those undergoing cesarean delivery. For a same Robson group, the chance of C-section increases when maternal age rises (OR\u2009=\u20093.33 for 41\u201345 years old), there is the presence of a partner (OR\u2009=\u20091.81) and prenatal care improves (OR\u2009=\u20093.19 for \u201cadequate plus\u201d).<\/jats:p><jats:p>\n          Conclusion\u2003There are indications that in the state of RJ, from 2015 to 2016, many cesarean deliveries were performed due to nonclinical factors.<\/jats:p>","DOI":"10.1055\/s-0040-1712122","type":"journal-article","created":{"date-parts":[[2020,7,31]],"date-time":"2020-07-31T22:34:57Z","timestamp":1596234897000},"page":"373-379","source":"Crossref","is-referenced-by-count":6,"title":["Pattern of Live Births in Rio de Janeiro State, Brazil, According to Robson Groups and the Kotelchuck Index Classification - 2015\/2016"],"prefix":"10.61622","volume":"42","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2309-6976","authenticated-orcid":false,"given":"Luciana Leite de Mattos","family":"Alcantara","sequence":"additional","affiliation":[{"name":"Programa de Engenharia Biom\u00e9dica, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3781-7391","authenticated-orcid":false,"given":"N\u00fabia Karla de Oliveira","family":"Almeida","sequence":"additional","affiliation":[{"name":"Departamento de Estat\u00edstica, Universidade Federal Fluminense, Niter\u00f3i, RJ, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0158-7432","authenticated-orcid":false,"given":"Renan Moritz Varnier Rodrigues de","family":"Almeida","sequence":"additional","affiliation":[{"name":"Programa de Engenharia Biom\u00e9dica, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"47794","published-online":{"date-parts":[[2020,7,31]]},"reference":[{"key":"ref1","volume-title":"WHO statement on caesarean section rates","year":"2015"},{"issue":"09","key":"ref2","first-page":"459","article-title":"[Evidence-based cesarean section indications: part II: [review]]","volume":"38","author":"A SR Souza","year":"2010","journal-title":"Femina"},{"issue":"01","key":"ref3","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1097\/AOG.0b013e31821e5f65","article-title":"Indications contributing to the increasing cesarean delivery rate","volume":"118","author":"E L Barber","year":"2011","journal-title":"Obstet Gynecol"},{"issue":"01","key":"ref4","first-page":"70","article-title":"Factors associated with cesarean sections in Brazilian hospitals","volume":"44","author":"K S P\u00e1dua","year":"2010","journal-title":"Rev Saude Publica"},{"issue":"01","key":"ref5","first-page":"34","article-title":"[Risk factors for the indication of caesarean section in Campinas (SP)]","volume":"29","author":"E F Carniel","year":"2007","journal-title":"Rev Bras Ginecol Obstet"},{"issue":"02","key":"ref6","doi-asserted-by":"crossref","first-page":"224","DOI":"10.1111\/1471-0528.12444","article-title":"Risk of retained placenta in women previously delivered by caesarean section: a population-based cohort study","volume":"121","author":"J Belachew","year":"2014","journal-title":"BJOG"},{"issue":"S 03","key":"ref7","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1186\/s12978-016-0228-7","article-title":"Use of Robson classification to assess cesarean section rate in Brazil: the role of source of payment for childbirth","volume":"13","author":"M Nakamura-Pereira","year":"2016","journal-title":"Reprod Health"},{"key":"ref8","doi-asserted-by":"crossref","first-page":"101","DOI":"10.11606\/S1518-8787.2017051007054","article-title":"Caesarean birth rates in public and privately funded hospitals: a cross-sectional study","volume":"51","author":"B D Alonso","year":"2017","journal-title":"Rev Saude Publica"},{"key":"ref9","first-page":"436","article-title":"Appropriate technology for birth","volume":"2","year":"1985","journal-title":"Lancet"},{"issue":"05","key":"ref11","doi-asserted-by":"crossref","first-page":"667","DOI":"10.1111\/1471-0528.13526","article-title":"WHO statement on caesarean section rates","volume":"123","author":"A P Betr\u00e1n","year":"2016","journal-title":"BJOG"},{"issue":"01","key":"ref12","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1053\/beog.2000.0156","article-title":"Can we reduce the caesarean section rate?","volume":"15","author":"M S Robson","year":"2001","journal-title":"Best Pract Res Clin Obstet Gynaecol"},{"issue":"03","key":"ref13","first-page":"134","article-title":"[Analysis of cesarean section rates and indications using ten group classification]","volume":"23","author":"D Almeida","year":"2014","journal-title":"Nascer Crescer"},{"issue":"09","key":"ref15","doi-asserted-by":"crossref","first-page":"1414","DOI":"10.2105\/AJPH.84.9.1414","article-title":"An evaluation of the Kessner adequacy of prenatal care index and a proposed adequacy of prenatal care utilization index","volume":"84","author":"M Kotelchuck","year":"1994","journal-title":"Am J Public Health"},{"issue":"02","key":"ref16","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1016\/j.bpobgyn.2012.09.004","article-title":"Methods of achieving and maintaining an appropriate caesarean section rate","volume":"27","author":"M Robson","year":"2013","journal-title":"Best Pract Res Clin Obstet Gynaecol"},{"key":"ref17","doi-asserted-by":"crossref","DOI":"10.1002\/9781118548387","volume-title":"Applied logistic regression. 3rd ed","author":"D W Hosmer Jr","year":"2013"},{"issue":"02","key":"ref18","doi-asserted-by":"crossref","first-page":"e0192997","DOI":"10.1371\/journal.pone.0192997","article-title":"Robson 10-groups classification system to access C-section in two public hospitals of the Federal District\/Brazil","volume":"13","author":"C V Bolognani","year":"2018","journal-title":"PLoS One"},{"issue":"01","key":"ref19","first-page":"11","article-title":"[Influence factors in the choice of the childbirth way: a literature review]","volume":"14","author":"A Minuzzi","year":"2013","journal-title":"Rev Uning\u00e1 Rev."},{"issue":"02","key":"ref20","doi-asserted-by":"crossref","first-page":"336","DOI":"10.1590\/0104-07072015000430014","article-title":"Determinants of women's preference for cesarean section","volume":"24","author":"F HS Copelli","year":"2015","journal-title":"Texto Contexto Enferm"}],"container-title":["Revista Brasileira de Ginecologia e Obstetr\u00edcia \/ RBGO Gynecology and 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