A Caesarean section can be a life-saving intervention in case of pregnancy complications or difficult labour. The prevalence of Caesarean section continues to increase, especially in sub-Saharan Africa, yet the reasons for this remain largely unexplored. This study investigated risk factors contributing to the decision to perform Caesarean sections in Ghana using data from 8645 women aged 15–49 years from the 2017 Ghana Maternal Health Survey. The data were analysed by applying complementary log-log and logit models. The majority of Ghanaian women (about 87%) reported preferring vaginal delivery to Caesarean section. Of those who had undergone a Caesarean section for their most recent birth, about 55% had an elective rather than an emergency section. Women with labour complications (prolonged/obstructed labour) were significantly more likely to have a Caesarean section (OR=4.09, 95% CI=3.10–5.41). Furthermore, women with maternal complications, particularly prolonged/obstructed labour, were less likely to have an elective Caesarean section than those who had no such complications (OR=0.25, 95% CI=0.14–0.46). Compared with poorer women, wealthy women were significantly more likely to have an elective Caesarean section (OR=1.84, 95% CI=1.08–3.14). The findings suggest that beyond maternal complications, women’s socioeconomic and demographic characteristics are important risk factors for undergoing a Caesarean section in Ghana.

中文翻译：

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加纳剖腹产的危险因素：来自加纳孕产妇健康调查的证据

在妊娠并发症或难产的情况下，剖腹产可能是一种挽救生命的干预措施。剖腹产的流行率继续增加，特别是在撒哈拉以南非洲地区，但其原因在很大程度上仍未被探索。本研究使用来自 2017 年加纳孕产妇健康调查的 8645 名 15-49 岁女性的数据，调查了促成在加纳进行剖腹产手术的风险因素。通过应用互补的 log-log 和 logit 模型分析数据。大多数加纳妇女（约 87%）报告说宁愿阴道分娩也不愿剖腹产。在最近一次分娩接受剖腹产的人中，约 55% 的人选择了择期而不是急诊。有分娩并发症（产程延长/难产）的女性进行剖宫产的可能性显着增加（OR=4.09, 95% CI=3.10–5.41）。此外，与没有此类并发症的女性相比，有产妇并发症，尤其是产程延长/难产的女性进行择期剖宫产的可能性更低（OR=0.25，95% CI=0.14-0.46）。与较贫穷的女性相比，富有的女性更有可能进行选择性剖腹产（OR=1.84, 95% CI=1.08-3.14）。研究结果表明，除了孕产妇并发症，女性的社会经济和人口特征是在加纳进行剖腹产的重要风险因素。与没有此类并发症的人相比，进行选择性剖腹产的可能性较小（OR=0.25, 95% CI=0.14-0.46）。与较贫穷的女性相比，富有的女性更有可能进行选择性剖腹产（OR=1.84, 95% CI=1.08-3.14）。研究结果表明，除了孕产妇并发症，女性的社会经济和人口特征是在加纳进行剖腹产的重要风险因素。与没有此类并发症的人相比，进行选择性剖腹产的可能性较小（OR=0.25, 95% CI=0.14-0.46）。与较贫穷的女性相比，富有的女性更有可能进行选择性剖腹产（OR=1.84, 95% CI=1.08-3.14）。研究结果表明，除了孕产妇并发症，女性的社会经济和人口特征是在加纳进行剖腹产的重要风险因素。