{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T06:18:40Z","timestamp":1791872320515,"version":"4.3.4"},"reference-count":63,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2015,3,9]],"date-time":"2015-03-09T00:00:00Z","timestamp":1425859200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"European Union in the framework of the Health Programme","award":["20101301"],"award-info":[{"award-number":["20101301"]}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2016,3]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To use data from routine sources to compare rates of obstetric intervention in Europe both overall and for subgroups at higher risk of intervention.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Retrospective analysis of aggregated routine data.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Thirty\u2010one European countries or regions contributing data on mode of delivery to the Euro\u2010Peristat project.<\/jats:p><\/jats:sec><jats:sec><jats:title>Population<\/jats:title><jats:p>Births in participating countries in 2010.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Countries provided aggregated data about overall rates of obstetric intervention and about caesarean section rates for specified subgroups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p>Mode of delivery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Rates of caesarean section ranged from 14.8% to 52.2% of all births and rates of instrumental vaginal delivery ranged from 0.5% to 16.4%. Overall, there was no association between rates of instrumental vaginal delivery and rates of caesarean section, but similarities were observed between some countries that are geographically close and may share common traditions of practice. Associations were observed between caesarean section rates for women with breech and vertex births and with singleton and multiple births but patterns of association for women who had and had not had previous caesarean sections were more complex.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The persisting wide variations in caesarean section and instrumental vaginal delivery rates point to a lack of consensus about practice and raise questions for further investigation. Further research is needed to explore the impact of differences in clinical guidelines, healthcare systems and their financing and parents\u2019 and professionals\u2019 attitudes to care at delivery.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.13284","type":"journal-article","created":{"date-parts":[[2015,3,9]],"date-time":"2015-03-09T07:56:00Z","timestamp":1425887760000},"page":"559-568","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":204,"title":["Wide differences in mode of delivery within Europe: risk\u2010stratified analyses of aggregated routine data from the Euro\u2010Peristat study"],"prefix":"10.1111","volume":"123","author":[{"given":"AJ","family":"Macfarlane","sequence":"first","affiliation":[{"name":"Centre for Maternal and Child Health Research City University London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B","family":"Blondel","sequence":"additional","affiliation":[{"name":"INSERM Obstetrical Perinatal and Paediatric Epidemiology Research Team Centre for Epidemiology and Biostatistics (U1153) Paris\u2010Descartes University Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"AD","family":"Mohangoo","sequence":"additional","affiliation":[{"name":"Department of Child Health TNO the Netherlands Organisation for Applied Scientific Research Leiden the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M","family":"Cuttini","sequence":"additional","affiliation":[{"name":"Research Unit of Perinatal Epidemiology Bambino Ges\u00f9 Children's Hospital Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J","family":"Nijhuis","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology GROW School of Oncology and Developmental Biology Maastricht University Medical Centre Maastricht the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Z","family":"Novak","sequence":"additional","affiliation":[{"name":"Perinatology Unit University Medical Centre Llubjana University Llubjana Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"HS","family":"\u00d3lafsd\u00f3ttir","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Landspitali University Hospital Landspitali v\/Hringbraut Iceland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J","family":"Zeitlin","sequence":"additional","affiliation":[{"name":"INSERM Obstetrical Perinatal and Paediatric Epidemiology Research Team Centre for Epidemiology and Biostatistics (U1153) Paris\u2010Descartes University Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the Euro\u2010Peristat Scientific Committee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2015,3,9]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(85)92750-3"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198702123160706"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/0140-6736(93)92874-S"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(06)68704-7"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1523-536X.2006.00118.x"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-3016.2007.00786.x"},{"key":"e_1_2_8_8_1","first-page":"470","article-title":"Caesarean section in countries of the Eastern Mediterranean Region","volume":"14","author":"Baldo MH","year":"2008","journal-title":"East Mediterr Health J"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(09)61870-5"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/EDE.0b013e318068646a"},{"key":"e_1_2_8_11_1","unstructured":"OECD.Health data2011. 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