Desigualdades sociais nas complicações da cesariana: uma análise hierarquizada Social inequalities in post-cesarean complication rates: a hierarchical analysis

Abstract This study focused on the association between social factors and complications following cesar-ean sections. A sample of 604 women delivering in the two main maternity hospitals in a city in southern Brazil were interviewed 24 hours after delivery and two weeks postpartum, using in-hospital and home interviews. Cox regression was applied, using a hierarchical framework of factors associated with post-cesarean complica-tions. Post-partum complications were twice as frequent after cesareans as compared to vaginal delivery, independently of socioeconomic condi-tions. However, the increased the risk of complica-tions associated with cesarean section proved to be mediated by socioeconomic circumstances, as represented by prenatal and childbirth care in the public health system, not having the same physi-cian throughout prenatal care and delivery, and having the decision made for the cesarean while the patient was already in labor. The study’s re-sults show that post-cesarean complications can adversely impact women, especially those living in the worst social and health conditions, that is, precisely those that lack support when returning home with a surgical wound.Cesarean Section; Postpartum Period; Social In-equity; Risk Factors