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Caesarean section and increased neonatal mortality risk in meta-analysis of 33 sub-Saharan Africa Demographic and Health Surveys
Authors: Tawa Olukade and Olalekan A. Uthman
Source: Acta Paediatrica, DOI: 10.1111/apa.16032
Topic(s): Cesarean section
Infant mortality
Country: Africa
  Multiple African Countries
Published: OCT 2021
Abstract: Aim: To examine the factors associated with the risk of neonatal mortality following caesarean births at country-level in sub-Saharan Africa. Methods: We used meta-analytic procedure to synthesize the results of most recent nationally representative cross-sectional Demographic and Health Survey (DHS) datasets for 33 sub-Saharan Africa countries conducted between 2010 and 2018. Pooled odds ratio (OR) and 95% confidence intervals (CI) were computed for all countries. Results: The overall caesarean section (CS) rate was 4.9%, neonatal mortality was 2.8% and Post-CS neonatal mortality was 4.3%. The rates of CS were generally low and only five countries had CS rates at or above 10%. The overall pooled result showed a statistically significant increase in the odds of neonatal mortality after a caesarean section (CS) OR 1.7 (95% CI 1.53 -1.89; I2 = 39.3%, p < 0.012); such that children delivered via CS were 70% more likely not to survive beyond the first 30 days. Geographical variations existed in the measure of association between caesarean section and neonatal mortality. Conclusion: This paper has provided evidence on the low rates of CS and the associated neonatal mortality risk compared to normal deliveries in sub-Saharan Africa.