Cesarean Section Rates and Indications in Turkey: A Systematic Review and Meta-Analysis

Background: The World Health Organization reports that acceptable cesarean section delivery rate would be 10%-15%. High cesarean rates in Turkey constitutes a risk to mother and baby health.

Aims: The aim of this study was to determine total and primary cesarean section rates and indications based on the results of studies conducted in Turkey.

Study Design: The aim of this study was to determine total and primary cesarean section rates and indications based on the results of studies conducted in Turkey.

Place and Duration of Study: The study was carried out over the period January 1-31, 2020 by means of a search of Turkish and English literature indexes.

Methodology: The study was carried out over the period January 1-31, 2020 by means of a search of Turkish and English literature indexes. The searching was carried out in the PubMed, Medline, EBSCO, Web of Science, Google Scholar, National Thesis Center, Dergipark, Ulakbim. The data extracted were combined through meta-analysis.

Results: Data from 31 cross-sectional studies and a total of 479.440 women were included in this systematic review and meta-analysis. It was determined that 177.484 of the women had undergone a cesarean delivery. The meta-analysis indicated that the estimated total cesarean rate was 43% (CI: 0.39-0.47; P< .001) while the primary cesarean rate was 26% CI: 0.12-0.47; P= .028). It was found that cesarean rates at the training/research hospitals (42%; CI: 0.39-0.45; P< .001) and university hospitals (69%; CI: 0.60-0.76; P< .001) were higher than at the state hospitals (29%; CI: 0.23-0.37; P< .001).It was seen that the estimated rates for the most common indications of cesarean births were, previous cesarean sections 46% (CI: 0.43-0.50; P= .051) and fetal distress 19% (CI: 0.15-0.23; P< .001).

Conclusion: The results of the study showed that cesarean rates are generally quite high, particularly at the training/research and university hospitals and that indications are varied.