Using Robson's Ten‐Group Classification System for comparing caesarean section rates in Europe: an analysis of routine data from the Euro‐Peristat study. (1st February 2021)

• Record Type: Journal Article
• Authors: Zeitlin, J; Durox, M; Macfarlane, A; Alexander, S; Heller, G; Loghi, M; Nijhuis, J; Sól Ólafsdóttir, H; Mierzejewska, E; Gissler, M; Blondel, B
• Other Names: Haidinger Gerald investigator.; Klimont Jeannette investigator.; Vandervelpen Gisèle investigator.; Zhang Wei‐Hong investigator.; Jordanova Evelin investigator.; Kolarova Rumyana investigator.; Filipovic‐Grcic Boris investigator.; Drausnik Zeljka investigator.; Rodin Urelija investigator.; Kyprianou Theopisti investigator.; Scoutellas Vasos investigator.; Velebil Petr investigator.; Mortensen Laust investigator.; Sakkeus Luule investigator.; Heino Anna investigator.; Chantry Anne investigator.; Deneux Tharaux Catherine investigator.; Lack Nicholas investigator.; Antsaklis Aris investigator.; Berbik István investigator.; Bonham Sheelagh investigator.; Kearns Karen investigator.; Sikora Izabela investigator.; Cuttini Marina investigator.; Misins Janis investigator.; Zile Irisa investigator.; Isakova Jelena investigator.; Billy Audrey investigator.; Couffignal Sophie investigator.; Lecomte Aline investigator.; Weber Guy investigator.; Gatt Miriam investigator.; Achterberg Peter investigator.; Broeders Lisa investigator.; Hindori‐Mohangoo Ashna investigator.; Akerkar Rupali investigator.; Klungsøyr Kari investigator.; Szamotulska Katarzyna investigator.; Barros Henrique investigator.; Horga Mihai investigator.; Tica Vlad investigator.; Cap Jan investigator.; Tul Natasa investigator.; Verdenik Ivan investigator.; Bolumar Francisco investigator.; Jané Mireia investigator.; Alcaide Adela Recio investigator.; Vidal Maria José investigator.; Zurriaga Oscar investigator.; Källén Karin investigator.; Nyman Anastasia investigator.; Berrut Sylvan investigator.; Riggenbach Mélanie investigator.; Rihs Tonia A investigator.; Smith Lucy investigator.; Wood Rachael investigator.; Delnord Marie investigator.; Hocquette Alice investigator.;
• Is Part Of: BJOG. Volume 128:Number 9(2021)
• Page Start: 1444
• Page End: 1453
• Publication Date: 2021-02-01
• Subjects: Caesarean birth -- Europe -- health information systems -- perinatal health indicators -- Robson classification -- Ten‐Group Classification System; Obstetrics -- Periodicals; Gynecology -- Periodicals; 618
• DOI: 10.1111/1471-0528.16634
• Languages: English
• ISSNs: 1470-0328

Abstract

Abstract : Objective: Robson's Ten Group Classification System (TGCS) creates clinically relevant sub‐groups for monitoring caesarean birth rates. This study assesses whether this classification can be derived from routine data in Europe and uses it to analyse national caesarean rates. Design: Observational study using routine data. Setting: Twenty‐seven EU member states plus Iceland, Norway, Switzerland and the UK. Population: All births at ≥22 weeks of gestational age in 2015. Methods: National statistical offices and medical birth registers derived numbers of caesarean births in TGCS groups. Main outcome measures: Overall caesarean rate, prevalence and caesarean rates in each of the TGCS groups. Results: Of 31 countries, 18 were able to provide data on the TGCS groups, with UK data available only from Northern Ireland. Caesarean birth rates ranged from 16.1 to 56.9%. Countries providing TGCS data had lower caesarean rates than countries without data (25.8% versus 32.9%, P = 0.04). Countries with higher caesarean rates tended to have higher rates in all TGCS groups. Substantial heterogeneity was observed, however, especially for groups 5 (previous caesarean section), 6, 7 (nulliparous/multiparous breech) and 10 (singleton cephalic preterm). The differences in percentages of abnormal lies, group 9, illustrate potential misclassification arising from unstandardised definitions. Conclusions: Although further validation of data quality is needed, using TGCS in Europe provides valuable comparator and baseline data for benchmarking and surveillance. Higher caesarean rates in countries unable to construct the TGCS suggest that effective routine information systems may be an indicator of a country's investment in implementing evidence‐based caesarean policies. Tweetable abstract: Many European countries can provide Robson's Ten‐Group Classification to improve caesarean rate comparisons. Tweetable abstract: Many European countries can provide Robson's Ten‐Group Classification to improve caesarean rate comparisons.