OB25 : Cesarean section and risk factors: Secular tends in South Korea, 2006-2015

Objective: The aim of the study is to investigate the recent trend in the rate of cesarean section (CS) in South Korea from 2006 to 2015 and identify risk factors in association with these changes. Methods: Using the National Health Insurance Corporation data, we included every women who had delivery from 2006 to 2015. We investigated (1) mode of delivery, (2) the rate of complications during pregnancy (i.e. preeclampsia and placenta previa) and (3) pre-pregnancy factors (BMI, hypertension, DM and other pre-existing medical conditions) and its trends during study period. Results: During 10 years, the rate of CS increased from 36.3% in 2006 to 40.6% in 2015 (p <0.01). The rate of CS increased in primiparous women, women with multiple pregnancy and women with preeclampsia. Otherwise, the rate of vacuum delivery and VBAC decreased during study period. The rate of women with pre-pregnancy obesity increased but the rate of women with pre-pregnancy hypertension and DM decreased. Conclusion: The rate of CS in South Korea have been increasing from 2006 to 2015. This trend may reflect changes in the rate of risk factors. Identification of causes for increasing trend of CS observed in this study will allow the clinician to monitor for these factors and possibly reduce CS.