TEMPORAL TRENDS AND DETERMINANTS OF CESAREAN BIRTH AMONG TURKISH AND FOREIGN-NATIONAL WOMEN: A RETROSPECTIVE COHORT STUDY

Öz

ABSTRACT Objective: To examine the change in cesarean delivery rates in Turkish national and foreign pregnant women over time, to determine the factors associated with cesarean section and to evaluate the effect of COVID-19 period. Method: A retrospective cohort study examined 2017 singular births in a health care provider between 2023 and 23,127 years. Due to missing calendar year data, the years 2017 and 2023 were not included in the time trend analysis; the analyses were conducted over 2018–2022 period, with 21,946 births. Categorical variables ki-square, continuous variables compared with independent sample t-test. The factors associated with cesarean delivery were evaluated by binary logistic regression. The models included nationality, maternal age, hemoglobin level, gravida, parity, year of birth and COVID-19 period. Results: Caesarean sections were found at 2018’ at 44.5%, 2019’ at 45.1%, 2020’ at 43.5%, 2021’ at 48.0% and 2022’ at 47.1%. The difference between the years was significant (p<0.001), and the likelihood of caesarean section increased over the years (OR=1.03; 95% GA: 1.01–1.05). Women with foreign nationality were less likely to have cesarean section (aOR=0.71; 95% GA: 0.66–0.75). Maternal age and increased gravida were associated with higher hemoglobin levels and increased parity were associated with lower possibility of cesarean section. Cesarean section increased in the post-COVID period (aOR=1.17; 95% GA: 1.10–1.24). Nationality × years and nationality × COVID period interactions found meaningful. The probability of low caesarean section in foreign women was significant during the period 2019–2021, while it decreased by 2022’. Conclusion: Caesarean sections were high and increased over time. Although cesarean section is less likely in foreign women, this difference has changed according to the years. It is recommended t

Anahtar Kelimeler

• Cesarean Section
• Emigrants and Immigrants
• Cohort Studies
• Retrospective Studies
• COVID-19
• Pregnant

Destekleyen Kurum

No

Etik Beyan

Ethics committee approval was obtained from the Interventional Ethics Committee of Karabük University with decision number 2026/2862 dated 07.04.2026.

SEZARYEN DOĞUMUN BELİRLEYİCİLERİ VE ZAMAN İÇİNDEKİ DEĞİŞİMİ: TÜRKİYE ULUSAL VE YABANCI ULUSLARARASI GEBELİK VERİLERİNDE RETROSPEKTİF KOHORT ANALİZİ

Öz

ÖZ Amaç: Türk ve yabancı uyruklu hamile kadınlarda sezaryen doğum oranlarındaki zaman içindeki değişimi incelemek, sezaryen doğumla ilişkili faktörleri belirlemek ve COVID-19 döneminin etkisini değerlendirmek. Yöntem: Retrospektif kohort çalışmasında, 2023 ile 23.127 yılları arasında bir sağlık kuruluşunda gerçekleşen 2017 tekil doğum incelenmiştir. Takvim yılı verilerinin eksik olması nedeniyle, 2017 ve 2023 yılları zaman trendi analizine dahil edilmemiştir; analizler 2018-2022 dönemi üzerinden 21.946 doğum ile yapılmıştır. Kategorik değişkenler için ki-kare testi, sürekli değişkenler için bağımsız örneklem t-testi kullanılmıştır. Sezaryen doğumla ilişkili faktörler ikili lojistik regresyon ile değerlendirilmiştir. Modeller, uyruk, anne yaşı, hemoglobin düzeyi, gebelik sayısı, doğum sayısı, doğum yılı ve COVID-19 dönemini içermiştir. Sonuçlar: Sezaryen doğum oranları 2018'de %44,5, 2019'da %45,1, 2020'de %43,5, 2021'de %48,0 ve 2022'de %47,1 olarak bulunmuştur. Yıllar arasındaki fark anlamlıydı (p<0,001) ve sezaryen doğum olasılığı yıllar içinde artmıştır (OR=1,03; %95 GA: 1,01–1,05). Yabancı uyruklu kadınlarda sezaryen doğum olasılığı daha düşüktü (aOR=0,71; %95 GA: 0,66–0,75). Anne yaşı ve artan gebelik sayısı daha yüksek hemoglobin seviyeleriyle ilişkiliydi ve artan doğum sayısı sezaryen doğum olasılığının daha düşük olmasıyla ilişkiliydi. Sezaryen doğum oranları COVID sonrası dönemde artmıştır (aOR=1,17; %95 GA: 1,10–1,24). Uyruk × yıllar ve uyruk × COVID dönemi etkileşimleri anlamlı bulunmuştur. Yabancı kadınlarda sezaryen doğum olasılığının düşük olması 2019-2021 döneminde anlamlı iken, 2022'de azalmıştır. Sonuç: Sezaryen doğum oranları yüksekti ve zaman içinde arttı. Yabancı kadınlarda sezaryen doğum olasılığı daha düşük olsa da, bu fark yıllara göre değişmiştir. Önerilenler şunlardır:

Anahtar Kelimeler

• Sezaryen Doğum
• Gebelik
• Göçmenler ve Yerleşik Nüfus
• Kohort Çalışmaları
• Retrospektif Çalışmalar
• COVID-19

Destekleyen Kurum

Yok

Etik Beyan

Çalışma için Karabük Üniversitesi Girişimsel Etik Kurulu'nun 07.04.2026 tarihli ve 2026/2862 numaralı kararıyla etik kurul onayı alınmıştır.

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