Determinants of Caesarean Risk Factor in Northern Region of Bangladesh: A Multivariate Analysis.

Background: Caesarean section (c-section) rates have been increasing dramatically in the past decades around the world. This increase has been attributed to multiple factors such as maternal, socio-demographic and institutional factors. Therefore, this study examines the impact of maternal, socio-demographic and relevant characteristics on caesarean delivery in the northern region of Bangladesh. Methods: This study is based on a total of 1142 delivery cases from four private hospitals and four public hospitals during the period of January to March 2010. The study was carried out using a cross-sectional design where data were collected by simple random sampling. In order to data analysis, first, an initial bivariate analysis was performed by the chi-square and Fisher exact test. Secondly, the risk factors which are associated with c-section identify by logistic regression model. Finally, a stepwise regression analysis was carried out to isolate the most influential risk factors. Results: Among the 17 risk factors, nine were found significantly associated with type of delivery. Eight of the risk factors i.e. previous c-section, pregnancy-induced swollen of leg, prolonged labour, maternal education status, maternal age more than 25 years, low birth order, length of baby more than 45cm and irregular intake of a balanced diet remained independently significant for caesarean delivery. The value of P<0.05 was considered statistically significant. Maternal complications were found to be more significant in public hospitals than in private ones and conversely for the demographic characteristics. Conclusion: The findings of this study suggested that the above factors may influence the health-seeking behaviour of women in the northern region of Bangladesh.