Analysis of mode of delivery according to race and ethnicity in Brazil: Application of the Robson Classification

Le résumé fourni par la source

OBJECTIVE: Cesarean section rates are one indicator of obstetric care quality. While low rates might reflect limited access to timely obstetric interventions, excessively high rates are not associated with better maternal or perinatal outcomes. Racial and ethnic disparities in maternal outcomes raise concerns about the equitable distribution of obstetric interventions in Brazil. The aim of this study was to analyze cesarean section rates across racial and ethnic groups in Brazil from 2012 to 2022, using the Robson Ten-Group Classification System. METHODS: This cross-sectional study used public data from the Live Birth Monitoring Panel, maintained by the Brazilian Ministry of Health. All hospital births from 2012 to 2022 were included. Deliveries were stratified by Robson group and self-reported race/color: White, Black, Mixed-race (Parda), Indigenous, and Asian. For each group, we calculated the proportion of total births, C-section rates, and contribution to overall cesarean numbers. Prevalence ratios were calculated using White women as the reference group. RESULTS: A total of 28 998 245 births were analyzed; 56.44% were cesarean deliveries. Cesarean rates were highest among White women (66.66%) and lowest among Indigenous women (21.23%). Robson Group 5 was the most prevalent and contributed the most to cesarean rates in all racial groups. Cesarean rates were consistently lower among Black, Mixed-race, Indigenous, and Asian women, across nearly all Robson groups. CONCLUSION: Marked racial disparities exist in cesarean rates in Brazil. These differences might reflect unequal access to obstetric interventions and raise concerns about equity in maternal health care.

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