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Faculty have requested this content not be shared on social media
CME Credit Offered
CME Credit Offered
Abstract Award
Abstract Award
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Poster Session 3

(759) Income-Level and Regional Variations and the Impact of Cesarean Delivery Rates on Maternal Mortality

Friday, January 31, 2025
10:30 AM – 12:30 PM  
Objective: To investigate the relationship between cesarean delivery (CD) and maternal mortality ratio (MMR) across different income levels and UNICEF regions.

Study Design: We conducted a cross-sectional analysis from 157 countries pooled from UNICEF database. To analyze interactions, we utilized a linear regression model. The model was built to account for variations due to income classifications by including dummy variables for each income level -Low Income (LI), Lower Middle Income (LMI) , Upper Middle Income (UMI), and High Income (HI) as defined by the World Bank. We controlled for the impact of income on MMR while isolating the effect of CD rates. Descriptive statistics and correlation analysis were used.

Results: Most UNICEF regions exhibit a negative correlation between CD rates and MMR, with the strongest correlations in Sub-Saharan Africa (-0.84) and South Asia (-0.68). In contrast, Eastern Europe and Central Asia show a weak positive correlation (0.43), indicating a slight increase in MMR with higher CD rates. When stratified for income group, CD rates were negatively correlated with MMR across all income groups but HI. The strongest negative correlation (-0.61) in LI countries indicates a significant decrease in MMR with higher CD rates. HI countries show a weak positive correlation (0.14), suggesting a slight increase in MMR with higher CD rates (Table 1). The regression analysis revealed that each % increase in CD rates corresponds to a reduction of approximately 4.4 units in MMR (p < 0.001). MMR was significantly higher in LI countries (coefficient: 370.18, p < 0.001) and LMI countries (coefficient: 159.06, p < 0.001) compared to HI countries. UMI countries had a coefficient of 61.84 with a p-value of 0.079, indicating no clear association with MMR (Table 2).

Conclusion:
Increasing the rate of CD was associated with a significant reduction in MMR in LI countries. In HI countries the correlation is weakly positive. This suggests that in LI countries an increase in CD rate may lower MMR; conversely in HI countries an increase in CD may be associated with increased MMR.