Cesarean Birth among Women Birthing in Asia: A Literature Synthesis using the Robson 10-Group Classification System
Asian Journal of Pregnancy and Childbirth,
Page 15-31
Abstract
There are increasing concerns about the advancing rates of Cesarean Birth (CB) worldwide as well as in Asia. However, less is known about the antecedent events and/or indicators contributing to rising CB rates. The Robson 10-Group Classification System (TGCS) facilitates comparisons of CB rates among subgroups of women with similar characteristics. While studies using the Robson TGCS have been conducted in Asia, findings from these studies have not been synthesized. This review article aimed to synthesize and critique the literature examining CB among women birthing in Asia using the Robson TGCS from January, 2011 to June, 2021. Of 396 publications, 25 studies met the inclusion criteria, were analyzed, and synthesized in this literature review. The findings show that the primary contributor to rising CB numbers/rates in Asian countries was Group 5 (multiparous women with a history of CB) followed by Group 2 (nulliparous women with induced labor or CB before labor began). Groups 6, 7, and 9 (women with fetal malpresentations) were the lowest contributors to overall CB rates. There was minimal variation in the distribution of Robson Groups across regions and HDI levels in Asia. The lack of consistency in reporting maternal age challenged understanding regarding the association between maternal age and Robson Group CB distribution patterns. Use of the Robson TGCS provides meaningful insight into antecedent events and indicators of CB numbers/rates. Future research should document maternal age, as prior literature suggests that older maternal age at delivery is associated with higher CB risk. These insights can provide opportunities for increased understanding of rising CB rates in Asia and, ultimately, the development of targeted and tailored interventions.
Keywords:
- Cesarean birth
- Robson 10-group classification
- Asia
- literature review.
How to Cite
Kanjanakaew, A., Driessnack, M., & Tilden, E. L. (2022). Cesarean Birth among Women Birthing in Asia: A Literature Synthesis using the Robson 10-Group Classification System. Asian Journal of Pregnancy and Childbirth, 5(1), 15-31. Retrieved from https://journalajpcb.com/index.php/AJPCB/article/view/30160
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Accessed April 23, 2021
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DOI:10.5005/jp-journals-10006-1420
Cagan M, Tanacan A, Hakli DA, Beksac MS. Changing rates of the modes of delivery over the decades (1976, 1986, 1996, 2006, and 2016) based on the Robson-10 group classification system in a single tertiary health care center. J Matern Fetal Neonatal Med. 2021;34(11):1695-1702.
DOI:10.1080/14767058.2019.1644619
Chung W, Kong C, To WW. Secular trends in caesarean section rates over 20 years in a regional obstetric unit in Hong Kong. Hong Kong Med J. Published online July 7, 2017.
DOI:10.12809/hkmj176217
Eyi EGY, Mollamahmutoglu L. An analysis of the high cesarean section rates in Turkey by Robson classification. J Matern Fetal Neonatal Med. 2021;34(16):2682-2692.
DOI:10.1080/14767058.2019.167080
Kankoon N, Lumbiganon P, Kietpeerakool C, Sangkomkamhang U, Betrán AP, Robson M. Cesarean rates and severe maternal and neonatal outcomes according to the Robson 10-Group Classification System in Khon Kaen Province, Thailand. Int J Gynecol Obstet. 2018;140(2):191-197.
DOI:10.1002/ijgo.12372
Karalasingam SD, Jeganathan R, Jegasothy R, Reidpath DD. Caesarean section rates from Malaysian tertiary hospitals using Robson’s 10-group classification. BMC Pregnancy Childbirth. 2020;20(1):64.
DOI:10.1186/s12884-020-2760-2
Malla RV, Hamal C, Neupane B, Khatri R. Analysis of Cesarean Section Using Robson’s 10-Group Classification at a Tertiary Level Hospital in Nepal. Med J Shree Birendra Hosp. 2018;17(2):4-11.
DOI:10.3126/mjsbh.v17i2.20290
Markandu T. Analysis of Caesarean Sections Using Robson Classification in Teaching Hospital Batticalao, Sri Lanka. Asian Res J Gynaecol Obstet. Published online September 12. 2020:6-11.
Naik M, Rani S, Ratnani R. Assessing cesarean section trends in a tertiary care teaching hospital using robson’s ten group classification. Int J Health Clin Res. 2021;4(8):215-218.
Parveen R, Khakwani M, Naz A, Bhatti R. Analysis of Cesarean Sections using Robson’s Ten Group Classification System. Pak J Med Sci. 2021;37(2):567-571.
DOI:10.12669/pjms.37.2.3823
Pukale RS, Joshi PS, Arathi MS. A Cross Sectional Study of Rate, Trends and Determinants of Caesarean Section among Mothers Attending a Rural Medical College Hospital in Karnataka. Indian J Obstet Gynecol Res. 2016;3(1):13.
DOI:10.5958/2394-2754.2016.00003.5
Rookesh Z, Zarshenas M, Akbarzadeh M. Prevalence of Cesarean Section Based on Robson’s Classification in Selected Delivery Centers of Shiraz University of Medical Sciences. Shiraz E-Med J. 2020;21(7).
DOI:10.5812/semj.96275
Senanayake H, Piccoli M, Valente EP, et al. Implementation of the WHO manual for Robson classification: an example from Sri Lanka using a local database for developing quality improvement recommendations. BMJ Open. 2019;9(2) :e027317.
DOI:10.1136/bmjopen-2018-027317
Sukmanee J, Liabsuetrakul T, Peeyananjarassri K. Rates and Indications of Cesarean Section Using the Robson Classification in a University Hospital in Southern Thailand 2014-2016. J Health Sci Med Res. 2020;38(4):307-319.
DOI:10.31584/jhsmr.2020749
Sungkar A, Santoso BI, Surya R, Fattah AN. Classifying cesarean section using Robson Classification: An Indonesian tertiary hospital survey. Maj Obstet Ginekol. 2019;27(2):66-70.
DOI:10.20473/mog.V27I22019.66-70
Tamang T, Dema J, Pelden S, Choden P. Usefulness of Robson classification system to analyze caesarean section deliveries: a hospital based study. Bhutan Health J. 2020;6(1):38-44.
DOI:10.47811/bhj.98
Tan JK, Tan EL, Kanagalingan D, Tan LK. Rational dissection of a high institutional cesarean section rate: An analysis using the Robson Ten Group Classification System. J Obstet Gynaecol Res. 2015; 41(4):534-539.
DOI:10.1111/jog.12608
Wen J, Chen Q, Luo Q. Analysing the likelihood of caesarean birth after implementation of the two-childbirth policy in China, using the Ten Group Classification System. J Obstet Gynaecol. 2020;40(3):336-341.
DOI:10.1080/01443615.2019.1624949
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