Prevalence and associated factors of caesarean section deliveries among child-bearing women in Iraq: Results of the 2018 multiple indicator cluster survey

Abstract

There has been an increase in the number of caesarean section (CS) deliveries in middle-income countries. The study aimed assess the prevalence and factors associated with CS delivery in Iraq. In the nationally representative 2018 Iraq “Multiple Indicator Cluster Survey”, 5444 mothers (15-49 years) with an institutional delivery in the past two years responded to questions on sociodemographic, social and medical variables. Logistic regression was used to investigate the association between household, maternal and health care characteristics and CS delivery. The prevalence of intra-institutional CS delivery was 38.3%, 30.1% in a public health care setting and 88.9% in a private health care setting. In adjusted logistic regression analysis, older maternal age (35-49 years) (Odds Ratio-OR: 1.52, 95% Confidence Interval CI: 1.12-2.06), higher level of mother’s education (OR: 1.33, 95% CI: 1.03-1.73), private health care delivery (OR: 16.13, 95% CI: 10.82- 24.05), 4-7 and 8 or more prenatal care visits (OR: 1.58, 95% CI: 1.27-1.97, and OR: 2.24, 95% CI: 1.63-3.08, respectively) and smaller than average size of newborn (OR: 1.51, 95% CI: 1.16-1.98) were associated with CS delivery. The study found a high intra-institutional CS rate, in particular in private health care institutions, and several determining factors for CS were identified.

Keywords: Caesarean section, deliveries, social factors, Iraq