# Determinants of Cesarean Delivery During Wartime in Atbara, Sudan: A Case-Control Study

## TL;DR

This study in Sudan found that previous cesarean delivery and rural residence are key factors influencing cesarean rates during wartime.

## Contribution

The study identifies specific determinants of cesarean delivery in a conflict-affected region, contributing to understanding healthcare practices under such conditions.

## Key findings

- Previous cesarean delivery strongly predicts future cesarean use (AOR = 43.25).
- Women from rural areas were more likely to have cesarean deliveries (AOR = 1.74).
- Factors like age, education, and antenatal care visits did not significantly influence cesarean delivery rates.

## Abstract

Background: Maintaining an optimal balance in cesarean delivery rates is important to prevent both overuse and underuse of the procedure. Efforts to optimize cesarean delivery rates should consider sociodemographic and obstetric risk factors.

Materials and methods: A case-control study was conducted on women who gave birth in Atbara Maternity Hospital to assess risk factors associated with cesarean deliveries. A questionnaire and hospital records were used to collect data.

Results: The cesarean delivery rate during the study period was 406 (39.69%). The study participants were 187 in the case group and 187 in the control group. The multiple regression analysis showed that history of previous cesarean delivery (adjusted odds ratio (AOR) = 43.25, 95% confidence interval (CI): 19.11−97.86, p ˂ 0.001) and rural residence (AOR = 1.74, 95% CI: 1.01−2.97, p= 0.045) were important determinants of cesarean delivery. Other factors, including age, parity, body mass index, educational level, consanguinity, displacement, maternal employment, number of antenatal care visits, previous history of miscarriage, and newborn birth weight, gender, and outcome, were not associated with cesarean delivery.

Conclusion: The history of previous cesarean deliveries and rural residences were the main determinants of cesarean deliveries in this study.