{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T03:09:41Z","timestamp":1780628981006,"version":"3.54.1"},"reference-count":23,"publisher":"Public Library of Science (PLoS)","issue":"10","license":[{"start":{"date-parts":[[2023,10,31]],"date-time":"2023-10-31T00:00:00Z","timestamp":1698710400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>Regular evaluation of caesarean section (CS) is required due to their rising trend and outcomes. Many women recently opt for elective CS, even in resource-constrained settings. Data evaluating the outcomes of CS is however sparse. Hence, this study sought to determine the rate of fetal mortalities and their determinants following CS in the Tatale District Hospital of the Northern Region, Ghana.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>A retrospective cross-sectional study was employed to analyze the medical records of 275 women who underwent CS from 2019 to 2021. Data were collected from the hospital\u2019s record of CS cases from 2019 to 2021. Descriptive statistics were used to summarize the data and Pearson\u2019s chi-square\/Fisher\u2019s exact test was used to examine the relationship between maternal and obstetric characteristics and fetal mortality. At a 95% confidence interval (95% CI), logistic regression was fitted to assess significant variables and reported the results using odds ratio.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>Of 1667 deliveries, 16.5% of the mothers gave birth by CS. A fetal mortality rate of 76.4 per 1000 total births was recorded following CS. Babies born with low Appearance, Pulse, Grimace, Activity and Respiration (APGAR) scores (0\u20133) at fifth-minute had an increased risk of fetal mortality (AOR\u2009 = \u2009523.19, 95%CI: 49.24\u20135559.37, p\u2009 = \u2009&lt;0.001). Having a history of previous CS, cephalopelvic disproportion and delayed labour were the major indications for CS.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>Overall, this study found a high rate of CS based on the World Health Organization\u2018s recommended CS rate. Interventions such as reducing the waiting time for surgery and early diagnosis of the need for CS, and ensuring the availability of modern equipment to resuscitate infants with low APGAR scores can significantly improve fetal outcomes following CS.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0293029","type":"journal-article","created":{"date-parts":[[2023,10,31]],"date-time":"2023-10-31T17:25:58Z","timestamp":1698773158000},"page":"e0293029","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":3,"title":["Fetal outcomes and their correlates following caesarian section in a rural setting in Ghana"],"prefix":"10.1371","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1630-2110","authenticated-orcid":true,"given":"Eugene","family":"Sackeya","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8130-0766","authenticated-orcid":true,"given":"Martin Muonibe","family":"Beru","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard Nomo","family":"Angmortey","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2321-387X","authenticated-orcid":true,"given":"Douglas Aninng","family":"Opoku","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victoria Achiaa","family":"Boamah","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francis","family":"Appiah","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aliyu","family":"Mohammed","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2023,10,31]]},"reference":[{"issue":"2","key":"pone.0293029.ref001","first-page":"e0148343","article-title":"The Increasing Trend in Caesarean Section Rates: Global, Regional and National Estimates: 1990\u20132014","volume":"11","author":"AP Betr\u00e1n","journal-title":"PLOS ONE. 2016 Feb 5"},{"issue":"6","key":"pone.0293029.ref002","doi-asserted-by":"crossref","first-page":"e005671","DOI":"10.1136\/bmjgh-2021-005671","article-title":"Trends and projections of caesarean section rates: global and regional estimates","volume":"6","author":"AP Betran","year":"2021","journal-title":"BMJ Glob Health"},{"key":"pone.0293029.ref003","article-title":"WHO Statement on Caesarean Section Rates","author":"World Health Organization","year":"2015"},{"issue":"4","key":"pone.0293029.ref004","doi-asserted-by":"crossref","first-page":"285.e1","DOI":"10.1016\/j.ajog.2012.10.883","article-title":"Correlation of arterial fetal base deficit and lactate changes with severity of variable heart rate decelerations in the near-term ovine fetus","volume":"208","author":"MG Ross","year":"2013","journal-title":"Am J Obstet Gynecol"},{"key":"pone.0293029.ref005","unstructured":"Limbs & Things. Limbs & Things. 2022. Increasing Rates of Caesarean Section: Implications for Training. Available from: https:\/\/limbsandthings.com\/global\/news\/36013\/increasing-caesarean-section-rates-and-the-implications-for-training [Accessed January 2023]"},{"key":"pone.0293029.ref006","doi-asserted-by":"crossref","first-page":"e0205977","DOI":"10.1371\/journal.pone.0205977","article-title":"Under five mortality patterns and associated maternal risk factors in sub-Saharan Africa: A multi-country analysis.","volume":"13","author":"S Yaya","year":"2018","journal-title":"PLOS ONE."},{"key":"pone.0293029.ref007","article-title":"Increasing caesarean sections in Africa could save more mothers lives.","author":"S Maswime","year":"2017","journal-title":"The Conversation."},{"issue":"07","key":"pone.0293029.ref008","doi-asserted-by":"crossref","first-page":"981","DOI":"10.4236\/ojog.2019.97095","article-title":"Maternal Complications of Caesarean Section in a Resource-Limited Country: The Case of the Maternity Unit of Kankan Regional Hospital, Guinea.","volume":"09","author":"MH Diallo","year":"2019","journal-title":"Open J Obstet Gynecol."},{"issue":"1","key":"pone.0293029.ref009","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1186\/s12884-020-2792-7","article-title":"Not just numbers: beyond counting caesarean deliveries to understanding their determinants in Ghana using a population based cross-sectional study.","volume":"20","author":"AA Seidu","year":"2020","journal-title":"BMC Pregnancy Childbirth."},{"issue":"3","key":"pone.0293029.ref010","doi-asserted-by":"crossref","first-page":"e007731","DOI":"10.1136\/bmjgh-2021-007731","article-title":"Mother and newborn skin-to-skin contact in sub-Saharan Africa: prevalence and predictors","volume":"7","author":"RG Aboagye","year":"2022","journal-title":"BMJ Glob Health"},{"issue":"20","key":"pone.0293029.ref011","article-title":"Predictors of caesarean section in Northern Ghana: a case-control study.","volume":"29","author":"PA Apanga","year":"2018","journal-title":"Pan Afr Med J"},{"issue":"5","key":"pone.0293029.ref012","doi-asserted-by":"crossref","first-page":"668","DOI":"10.1007\/s10995-020-02895-6","article-title":"Determinants of Low Birth Weight in Ghana: Does Quality of Antenatal Care Matter?","volume":"24","author":"E Banchani","year":"2020","journal-title":"Matern Child Health J."},{"key":"pone.0293029.ref013","article-title":"Caesarean section in a primary health facility in Ghana: Clinical indications and feto-maternal outcomes.","author":"J Prah","year":"2017","journal-title":"J Public Health Afr."},{"key":"pone.0293029.ref014","article-title":"Low Apgar score and asphyxia complications at birth and risk of longer-term cardiovascular disease: a nationwide population-based study of term infants","author":"N Razaz","journal-title":"Lancet Reg Health\u2013Eu"},{"issue":"6","key":"pone.0293029.ref015","doi-asserted-by":"crossref","first-page":"445","DOI":"10.2471\/BLT.16.179531","article-title":"Developing global indicators for quality of maternal and newborn care: a feasibility assessment","volume":"95","author":"B Madaj","year":"2017","journal-title":"Bull World Health Organ"},{"issue":"1","key":"pone.0293029.ref016","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1186\/s12884-019-2173-2","article-title":"Indicators for monitoring maternal and neonatal quality care: a systematic review.","volume":"19","author":"PJ Saturno-Hern\u00e1ndez","year":"2019","journal-title":"BMC Pregnancy Childbirth."},{"issue":"11","key":"pone.0293029.ref017","doi-asserted-by":"crossref","first-page":"14690","DOI":"10.3390\/ijerph121114690","article-title":"Caesarean Section\u2014A Density-Equalizing Mapping Study to Depict Its Global Research Architecture.","volume":"12","author":"D Br\u00fcggmann","year":"2015","journal-title":"Int J Environ Res Public Health"},{"key":"pone.0293029.ref018","author":"DHS","year":"2017","journal-title":"Ghana Special Demographic and Health Survey 2017 | GHDx"},{"issue":"3","key":"pone.0293029.ref019","doi-asserted-by":"crossref","first-page":"e0263837","DOI":"10.1371\/journal.pone.0263837","article-title":"Determinants of early neonatal outcomes after emergency cesarean delivery at Hawassa University comprehensive specialised hospital, Hawassa, Ethiopia.","volume":"17","author":"S Elias","year":"2022","journal-title":"PLOS ONE."},{"issue":"8","key":"pone.0293029.ref020","doi-asserted-by":"crossref","first-page":"e1074","DOI":"10.1016\/S2214-109X(19)30165-2","article-title":"Does facility birth reduce maternal and perinatal mortality in Brong Ahafo, Ghana? A secondary analysis using data on 119\u2008244 pregnancies from two cluster-randomised controlled trials","volume":"7","author":"S Gabrysch","year":"2019","journal-title":"Lancet Glob Health"},{"issue":"1","key":"pone.0293029.ref021","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1186\/s12873-017-0128-3","article-title":"Incidence and outcome of severe ante-partum hemorrhage at the Teaching Hospital Yalgado Ou\u00e9draogo in Burkina Faso.","volume":"17","author":"M Lankoande","year":"2017","journal-title":"BMC Emerg Med."},{"key":"pone.0293029.ref022","doi-asserted-by":"crossref","first-page":"l1656","DOI":"10.1136\/bmj.l1656","article-title":"Association between Apgar scores of 7 to 9 and neonatal mortality and morbidity: population based cohort study of term infants in Sweden","volume":"365","author":"N Razaz","year":"2019","journal-title":"BMJ"},{"key":"pone.0293029.ref023","author":"American Academy of Pediatrics","year":"2022","journal-title":"The Apgar Score"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0293029","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,31]],"date-time":"2023-10-31T17:26:20Z","timestamp":1698773180000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0293029"}},"subtitle":[],"editor":[{"given":"Sanjoy Kumer","family":"Dey","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2023,10,31]]},"references-count":23,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2023,10,31]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0293029","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,10,31]]}}}