Cesarean section trends in the Nordic Countries – a comparative analysis with the Robson classification

Introduction The cesarean rates are low but increasing in most Nordic countries. Using the Robson classification, we analyzed which obstetric groups have contributed to the changes in the cesarean rates. Material and methods Retrospective population‐based registry study including all deliveries (3 3...

Full description

Saved in:

Bibliographic Details
Published in:	Acta obstetricia et gynecologica Scandinavica Vol. 96; no. 5; pp. 607 - 616
Main Authors:	Pyykönen, Aura, Gissler, Mika, Løkkegaard, Ellen, Bergholt, Thomas, Rasmussen, Steen C., Smárason, Alexander, Bjarnadóttir, Ragnheiður I., Másdóttir, Birna B., Källén, Karin, Klungsoyr, Kari, Albrechtsen, Susanne, Skjeldestad, Finn E., Tapper, Anna‐Maija
Format:	Journal Article
Language:	English
Published:	United States John Wiley & Sons, Inc 01.05.2017
Subjects:	Cesarean section Cesarean Section - statistics & numerical data Cesarean Section - trends Classification Clinical Medicine Databases, Factual delivery Female Gynaecology, Obstetrics and Reproductive Medicine Gynekologi, obstetrik och reproduktionsmedicin Health risk assessment Humans induction of labor Infant, Newborn Klinisk medicin Maternal Health Services - statistics & numerical data Maternal Health Services - trends Medical and Health Sciences Medicin och hälsovetenskap Physicians Pregnancy Pregnancy Outcome Retrospective Studies Robson classification Scandinavian and Nordic Countries - epidemiology uterine scar Robson classification delivery induction of labor uterine scar Cesarean section
ISSN:	0001-6349, 1600-0412
Online Access:	Get full text
Tags:	Add Tag No Tags, Be the first to tag this record!

Abstract	Introduction The cesarean rates are low but increasing in most Nordic countries. Using the Robson classification, we analyzed which obstetric groups have contributed to the changes in the cesarean rates. Material and methods Retrospective population‐based registry study including all deliveries (3 398 586) between 2000 and 2011 in Denmark, Finland, Iceland, Norway and Sweden. The Robson group distribution, cesarean rate and contribution of each Robson group were analyzed nationally for four 3‐year time periods. For each country, we analyzed which groups contributed to the change in the total cesarean rate. Results Between the first and the last time period studied, the total cesarean rates increased in Denmark (16.4 to 20.7%), Norway (14.4 to 16.5%) and Sweden (15.5 to 17.1%), but towards the end of our study, the cesarean rates stabilized or even decreased. The increase was explained mainly by increases in the absolute contribution from R5 (women with previous cesarean) and R2a (induced labor on nulliparous). In Finland, the cesarean rate decreased slightly (16.5 to 16.2%) mainly due to decrease among R5 and R6–R7 (breech presentation, nulliparous/multiparous). In Iceland, the cesarean rate decreased in all parturient groups (17.6 to 15.3%), most essentially among nulliparous women despite the increased induction rates. Conclusions The increased total cesarean rates in the Nordic countries are explained by increased cesarean rates among nulliparous women, and by an increased percentage of women with previous cesarean. Meanwhile, induction rates on nulliparous increased significantly, but the impact on the total cesarean rate was unclear. The Robson classification facilitates benchmarking and targeting efforts for lowering the cesarean rates.
AbstractList	Introduction The cesarean rates are low but increasing in most Nordic countries. Using the Robson classification, we analyzed which obstetric groups have contributed to the changes in the cesarean rates. Material and methods Retrospective population‐based registry study including all deliveries (3 398 586) between 2000 and 2011 in Denmark, Finland, Iceland, Norway and Sweden. The Robson group distribution, cesarean rate and contribution of each Robson group were analyzed nationally for four 3‐year time periods. For each country, we analyzed which groups contributed to the change in the total cesarean rate. Results Between the first and the last time period studied, the total cesarean rates increased in Denmark (16.4 to 20.7%), Norway (14.4 to 16.5%) and Sweden (15.5 to 17.1%), but towards the end of our study, the cesarean rates stabilized or even decreased. The increase was explained mainly by increases in the absolute contribution from R5 (women with previous cesarean) and R2a (induced labor on nulliparous). In Finland, the cesarean rate decreased slightly (16.5 to 16.2%) mainly due to decrease among R5 and R6–R7 (breech presentation, nulliparous/multiparous). In Iceland, the cesarean rate decreased in all parturient groups (17.6 to 15.3%), most essentially among nulliparous women despite the increased induction rates. Conclusions The increased total cesarean rates in the Nordic countries are explained by increased cesarean rates among nulliparous women, and by an increased percentage of women with previous cesarean. Meanwhile, induction rates on nulliparous increased significantly, but the impact on the total cesarean rate was unclear. The Robson classification facilitates benchmarking and targeting efforts for lowering the cesarean rates. Introduction: The cesarean rates are low but increasing in most Nordic countries. Using the Robson classification, we analyzed which obstetric groups have contributed to the changes in the cesarean rates. Material and methods: Retrospective population-based registry study including all deliveries (3 398 586) between 2000 and 2011 in Denmark, Finland, Iceland, Norway and Sweden. The Robson group distribution, cesarean rate and contribution of each Robson group were analyzed nationally for four 3-year time periods. For each country, we analyzed which groups contributed to the change in the total cesarean rate. Results: Between the first and the last time period studied, the total cesarean rates increased in Denmark (16.4 to 20.7%), Norway (14.4 to 16.5%) and Sweden (15.5 to 17.1%), but towards the end of our study, the cesarean rates stabilized or even decreased. The increase was explained mainly by increases in the absolute contribution from R5 (women with previous cesarean) and R2a (induced labor on nulliparous). In Finland, the cesarean rate decreased slightly (16.5 to 16.2%) mainly due to decrease among R5 and R6-R7 (breech presentation, nulliparous/multiparous). In Iceland, the cesarean rate decreased in all parturient groups (17.6 to 15.3%), most essentially among nulliparous women despite the increased induction rates. Conclusions: The increased total cesarean rates in the Nordic countries are explained by increased cesarean rates among nulliparous women, and by an increased percentage of women with previous cesarean. Meanwhile, induction rates on nulliparous increased significantly, but the impact on the total cesarean rate was unclear. The Robson classification facilitates benchmarking and targeting efforts for lowering the cesarean rates. INTRODUCTIONThe cesarean rates are low but increasing in most Nordic countries. Using the Robson classification, we analyzed which obstetric groups have contributed to the changes in the cesarean rates.MATERIAL AND METHODSRetrospective population-based registry study including all deliveries (3 398 586) between 2000 and 2011 in Denmark, Finland, Iceland, Norway and Sweden. The Robson group distribution, cesarean rate and contribution of each Robson group were analyzed nationally for four 3-year time periods. For each country, we analyzed which groups contributed to the change in the total cesarean rate.RESULTSBetween the first and the last time period studied, the total cesarean rates increased in Denmark (16.4 to 20.7%), Norway (14.4 to 16.5%) and Sweden (15.5 to 17.1%), but towards the end of our study, the cesarean rates stabilized or even decreased. The increase was explained mainly by increases in the absolute contribution from R5 (women with previous cesarean) and R2a (induced labor on nulliparous). In Finland, the cesarean rate decreased slightly (16.5 to 16.2%) mainly due to decrease among R5 and R6-R7 (breech presentation, nulliparous/multiparous). In Iceland, the cesarean rate decreased in all parturient groups (17.6 to 15.3%), most essentially among nulliparous women despite the increased induction rates.CONCLUSIONSThe increased total cesarean rates in the Nordic countries are explained by increased cesarean rates among nulliparous women, and by an increased percentage of women with previous cesarean. Meanwhile, induction rates on nulliparous increased significantly, but the impact on the total cesarean rate was unclear. The Robson classification facilitates benchmarking and targeting efforts for lowering the cesarean rates. The cesarean rates are low but increasing in most Nordic countries. Using the Robson classification, we analyzed which obstetric groups have contributed to the changes in the cesarean rates. Retrospective population-based registry study including all deliveries (3 398 586) between 2000 and 2011 in Denmark, Finland, Iceland, Norway and Sweden. The Robson group distribution, cesarean rate and contribution of each Robson group were analyzed nationally for four 3-year time periods. For each country, we analyzed which groups contributed to the change in the total cesarean rate. Between the first and the last time period studied, the total cesarean rates increased in Denmark (16.4 to 20.7%), Norway (14.4 to 16.5%) and Sweden (15.5 to 17.1%), but towards the end of our study, the cesarean rates stabilized or even decreased. The increase was explained mainly by increases in the absolute contribution from R5 (women with previous cesarean) and R2a (induced labor on nulliparous). In Finland, the cesarean rate decreased slightly (16.5 to 16.2%) mainly due to decrease among R5 and R6-R7 (breech presentation, nulliparous/multiparous). In Iceland, the cesarean rate decreased in all parturient groups (17.6 to 15.3%), most essentially among nulliparous women despite the increased induction rates. The increased total cesarean rates in the Nordic countries are explained by increased cesarean rates among nulliparous women, and by an increased percentage of women with previous cesarean. Meanwhile, induction rates on nulliparous increased significantly, but the impact on the total cesarean rate was unclear. The Robson classification facilitates benchmarking and targeting efforts for lowering the cesarean rates.
Author	Bjarnadóttir, Ragnheiður I. Bergholt, Thomas Rasmussen, Steen C. Albrechtsen, Susanne Skjeldestad, Finn E. Klungsoyr, Kari Smárason, Alexander Tapper, Anna‐Maija Pyykönen, Aura Källén, Karin Gissler, Mika Másdóttir, Birna B. Løkkegaard, Ellen
Author_xml	– sequence: 1 givenname: Aura orcidid: 0000-0001-9968-6660 surname: Pyykönen fullname: Pyykönen, Aura email: aura.pyykonen@helsinki.fi organization: Helsinki University Hospital – sequence: 2 givenname: Mika orcidid: 0000-0001-8254-7525 surname: Gissler fullname: Gissler, Mika organization: Karolinska Institute – sequence: 3 givenname: Ellen surname: Løkkegaard fullname: Løkkegaard, Ellen organization: Nordsjælland Hospital – sequence: 4 givenname: Thomas surname: Bergholt fullname: Bergholt, Thomas organization: Rigshospitalet – sequence: 5 givenname: Steen C. surname: Rasmussen fullname: Rasmussen, Steen C. organization: Rigshospitalet – sequence: 6 givenname: Alexander surname: Smárason fullname: Smárason, Alexander organization: University of Akureyri – sequence: 7 givenname: Ragnheiður I. orcidid: 0000-0003-0503-1319 surname: Bjarnadóttir fullname: Bjarnadóttir, Ragnheiður I. organization: Landspitali University Hospital – sequence: 8 givenname: Birna B. surname: Másdóttir fullname: Másdóttir, Birna B. organization: Landspitali University Hospital – sequence: 9 givenname: Karin orcidid: 0000-0001-5765-2630 surname: Källén fullname: Källén, Karin organization: University of Lund – sequence: 10 givenname: Kari surname: Klungsoyr fullname: Klungsoyr, Kari organization: University of Bergen – sequence: 11 givenname: Susanne surname: Albrechtsen fullname: Albrechtsen, Susanne organization: Haukeland University Hospital – sequence: 12 givenname: Finn E. surname: Skjeldestad fullname: Skjeldestad, Finn E. organization: UiT the Arctic University of Norway – sequence: 13 givenname: Anna‐Maija orcidid: 0000-0001-9352-0125 surname: Tapper fullname: Tapper, Anna‐Maija organization: Hyvinkää Hospital
BackLink	https://www.ncbi.nlm.nih.gov/pubmed/28176334$$D View this record in MEDLINE/PubMed http://kipublications.ki.se/Default.aspx?queryparsed=id:135693542$$DView record from Swedish Publication Index (Karolinska Institutet)
BookMark	eNp9ks1uEzEQxy1URNPChQdAK3FBSFv8tV77WEVQkCoq8XG2JvaEuGzWwd4lyo134A15ErxJ6KECfPHY_v3_47HnjJz0sUdCnjJ6wcp4BfFLvmCCUf2AzJiitKaS8RMyo5SyWglpTslZzrdlxVupH5FTrlmrhJAzEuaYISH0VUY3hNhXQ8Le5yqUaIXV-5h8cNU8jv2QAubq14-fFVQurjeQYAjfsYIeul0OudqGYbUXfYiLXJxcBzmHZXAwGT8mD5fQZXxynM_J5zevP83f1tc3V-_ml9e1azjTNSBy11DVMK-p1sK4lmvfCmDQtsoos2hU6zn3S0VdOXWSMy-dE1620IhGnJP64Ju3uBkXdpPCGtLORgj2uPW1RGilMZyrwsM_-U1MA3Q2YUZIbmW7cRIWqjsWlW3xANMIYz0qbqVecAuSaUuF8qIxmjsuS44XhxybFL-NmAe7Dtlh10GPccyWaaW4keVzCvr8Hnobx1SeeKK0McIoNhX57EiNizX6u0v_-dgCvDwALsWcEy7vEEbt1DV26hq775oC03uwC8O-viFB6P4uYQfJNnS4-4-5vby5-njQ_AZbrtWm
CODEN	AOGSAE
CitedBy_id	crossref_primary_10_1590_0102_311xen073621 crossref_primary_10_1186_s12884_023_05803_2 crossref_primary_10_1038_s41598_019_55389_z crossref_primary_10_1002_ijgo_12842 crossref_primary_10_1038_s41598_018_36416_x crossref_primary_10_1055_s_0042_1753547 crossref_primary_10_1080_16549716_2020_1748403 crossref_primary_10_1097_MD_0000000000019880 crossref_primary_10_1155_2018_6764258 crossref_primary_10_1371_journal_pmed_1003764 crossref_primary_10_1371_journal_pmed_1004077 crossref_primary_10_1016_j_annepidem_2025_04_008 crossref_primary_10_1097_AOG_0000000000003618 crossref_primary_10_1007_s00404_022_06601_5 crossref_primary_10_1186_s12884_022_04517_1 crossref_primary_10_1111_aogs_14235 crossref_primary_10_3390_jcm10061196 crossref_primary_10_1080_01443615_2020_1718625 crossref_primary_10_1111_aogs_13743 crossref_primary_10_1136_bmjopen_2018_025073 crossref_primary_10_1111_aogs_13341 crossref_primary_10_1371_journal_pone_0239724 crossref_primary_10_1136_bmjopen_2020_044383 crossref_primary_10_1038_s41598_019_46200_0 crossref_primary_10_3390_jcm14082700 crossref_primary_10_3390_jcm12196426 crossref_primary_10_1590_0102_311xpt073621 crossref_primary_10_1038_s41598_019_57037_y crossref_primary_10_1186_s12884_022_04755_3 crossref_primary_10_3390_jcm13010252 crossref_primary_10_4103_aam_aam_54_17 crossref_primary_10_1016_j_jogc_2019_09_009 crossref_primary_10_1111_birt_12353 crossref_primary_10_54033_cadpedv22n10_030 crossref_primary_10_1111_aogs_14609 crossref_primary_10_1111_jog_15522 crossref_primary_10_1017_S0033291721002324 crossref_primary_10_1111_aogs_13557 crossref_primary_10_1016_j_ejogrb_2019_04_044 crossref_primary_10_1016_j_ejogrb_2024_11_052 crossref_primary_10_1016_j_placenta_2025_02_007 crossref_primary_10_1111_aogs_13751 crossref_primary_10_1016_j_ajog_2018_05_026 crossref_primary_10_1111_birt_12409 crossref_primary_10_1002_ijgo_70500 crossref_primary_10_1515_jpm_2020_0505 crossref_primary_10_1111_1471_0528_16647 crossref_primary_10_1080_07399332_2019_1623800 crossref_primary_10_1093_rap_rkad062 crossref_primary_10_1111_1471_0528_17019 crossref_primary_10_1136_bmjopen_2018_027317 crossref_primary_10_1111_birt_12564 crossref_primary_10_1590_0102_311xen154024 crossref_primary_10_1055_s_0040_1712134 crossref_primary_10_1002_ijgo_15826 crossref_primary_10_1136_bmjopen_2022_065004 crossref_primary_10_1002_ijgo_14817 crossref_primary_10_1186_s12884_020_03440_7 crossref_primary_10_1002_ijgo_14610 crossref_primary_10_3390_life13102016 crossref_primary_10_1111_all_13468 crossref_primary_10_1155_2024_3774435 crossref_primary_10_1016_j_srhc_2021_100641 crossref_primary_10_1111_aogs_13683 crossref_primary_10_1111_aogs_14333 crossref_primary_10_1136_jnnp_2023_331241 crossref_primary_10_1371_journal_pone_0234727 crossref_primary_10_1111_1471_0528_16634 crossref_primary_10_1136_bmjopen_2021_052323 crossref_primary_10_1111_birt_12415 crossref_primary_10_1016_j_ajog_2020_10_004 crossref_primary_10_1111_jep_13208 crossref_primary_10_1016_j_ajog_2023_10_029 crossref_primary_10_1111_1471_0528_17760 crossref_primary_10_1016_j_ejogrb_2020_03_014
Cites_doi	10.1016/j.ajog.2009.06.021 10.1016/j.ejogrb.2010.09.005 10.1016/j.medici.2015.09.001 10.1371/journal.pone.0014566 10.1017/S0965539501000122 10.6027/Nord2014-001 10.1111/1471-0528.13199 10.1016/j.ejogrb.2015.03.030 10.1371/journal.pone.0148138 10.1787/health_glance-2013-en 10.1186/s12978-015-0043-6 10.1111/1471-0528.13509 10.1016/j.bpobgyn.2012.09.004 10.1053/beog.2000.0156 10.1111/1471-0528.13284 10.1371/journal.pone.0148343 10.1371/journal.pone.0097769 10.1111/j.1479-828X.2009.01100.x 10.1016/S2214-109X(15)70094-X
ContentType	Journal Article
Copyright	2017 Nordic Federation of Societies of Obstetrics and Gynecology 2017 Nordic Federation of Societies of Obstetrics and Gynecology. Copyright © 2017 Acta Obstetricia et Gynecologica Scandinavica
Copyright_xml	– notice: 2017 Nordic Federation of Societies of Obstetrics and Gynecology – notice: 2017 Nordic Federation of Societies of Obstetrics and Gynecology. – notice: Copyright © 2017 Acta Obstetricia et Gynecologica Scandinavica
CorporateAuthor	Miljöepidemiologi Section V Institutionen för kliniska vetenskaper, Lund Lunds universitet Profile areas and other strong research environments Department of Laboratory Medicine Lund University Avdelningen för arbets- och miljömedicin Sektion V Obstetrics and Gynaecology (Lund) Institutionen för laboratoriemedicin Department of Clinical Sciences, Lund Division of Occupational and Environmental Medicine, Lund University Strategiska forskningsområden (SFO) EpiHealth: Epidemiology for Health Obstetrik och gynekologi, Lund Faculty of Medicine Strategic research areas (SRA) Medicinska fakulteten Environmental Epidemiology Tornblad Institute Profilområden och andra starka forskningsmiljöer Tornbladinstitutet
CorporateAuthor_xml	– name: Faculty of Medicine – name: Medicinska fakulteten – name: Strategiska forskningsområden (SFO) – name: Department of Laboratory Medicine – name: EpiHealth: Epidemiology for Health – name: Institutionen för kliniska vetenskaper, Lund – name: Avdelningen för arbets- och miljömedicin – name: Strategic research areas (SRA) – name: Lunds universitet – name: Department of Clinical Sciences, Lund – name: Obstetrics and Gynaecology (Lund) – name: Profilområden och andra starka forskningsmiljöer – name: Lund University – name: Institutionen för laboratoriemedicin – name: Sektion V – name: Obstetrik och gynekologi, Lund – name: Environmental Epidemiology – name: Miljöepidemiologi – name: Section V – name: Profile areas and other strong research environments – name: Tornbladinstitutet – name: Division of Occupational and Environmental Medicine, Lund University – name: Tornblad Institute
DBID	AAYXX CITATION CGR CUY CVF ECM EIF NPM K9. 7X8 ADTPV AOWAS D95
DOI	10.1111/aogs.13108
DatabaseName	CrossRef Medline MEDLINE MEDLINE (Ovid) MEDLINE MEDLINE PubMed ProQuest Health & Medical Complete (Alumni) MEDLINE - Academic SwePub SwePub Articles SWEPUB Lunds universitet
DatabaseTitle	CrossRef MEDLINE Medline Complete MEDLINE with Full Text PubMed MEDLINE (Ovid) ProQuest Health & Medical Complete (Alumni) MEDLINE - Academic
DatabaseTitleList	MEDLINE - Academic ProQuest Health & Medical Complete (Alumni) MEDLINE
Database_xml	– sequence: 1 dbid: NPM name: PubMed url: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed sourceTypes: Index Database – sequence: 2 dbid: 7X8 name: MEDLINE - Academic url: https://search.proquest.com/medline sourceTypes: Aggregation Database
DeliveryMethod	fulltext_linktorsrc
Discipline	Medicine
EISSN	1600-0412
EndPage	616
ExternalDocumentID	oai_swepub_ki_se_499226 oai_portal_research_lu_se_publications_922a9539_de62_48b2_a418_036d35982c24 4321863805 28176334 10_1111_aogs_13108 AOGS13108
Genre	article Journal Article Comparative Study
GroupedDBID	--- .3N .55 .GA .GJ .Y3 05W 0R~ 1OB 1OC 23M 24P 31~ 34G 36B 39C 3O- 3SF 4.4 50Y 50Z 52M 52O 52T 52U 52V 52W 53G 5GY 5HH 5RE 5VS 702 7PT 7X7 8-0 8-1 8-3 8-4 8-5 8FI 8FJ 930 A01 A03 AAESR AAEVG AAFWJ AAKAS AAMMB AANHP AAONW AAPXX AAYCA AAZKR ABCUV ABJNI ABPVW ABTOO ABUWG ACAHQ ACBWZ ACCMX ACGFS ACMXC ACPOU ACRPL ACXQS ACYXJ ADBBV ADCVX ADEOM ADIYS ADIZJ ADKYN ADMGS ADNMO ADOZA ADPDF ADXAS ADZCM ADZMN AEFGJ AEIMD AENEX AFBPY AFEBI AFFNX AFGKR AFKRA AFKVX AFPKN AFZJQ AGQPQ AGXDD AHMBA AI. AIACR AIDQK AIDYY AIJEM AIQQE AIURR AJWEG ALAGY ALMA_UNASSIGNED_HOLDINGS ALUQN AMBMR AMYDB AQTUD ASPBG ATUGU AVWKF AZBYB AZFZN AZVAB BAFTC BDRZF BENPR BFHJK BHBCM BMXJE BROTX BRXPI CAG CCPQU COF CS3 D-6 D-7 D-E D-F DCZOG DPXWK DRFUL DRMAN DRSTM DUUFO EBS EJD EMOBN EX3 F00 F01 F04 F21 F5P FEDTE FUBAC FYUFA G-S GODZA GROUPED_DOAJ H.X HF~ HMCUK HVGLF HZ~ IHE KBYEO L7B LATKE LEEKS LH4 LITHE LOXES LP6 LP7 LUTES LW6 LYRES M44 MK4 MRFUL MRMAN MRSTM MSFUL MSMAN MSSTM MXFUL MXMAN MXSTM MY~ N04 N05 NF~ O66 OK1 OVD OVEED P2P P2W P2X P2Z P4B P4D PALCI PHGZM PQQKQ Q.N QB0 R.K RIWAO RJQFR ROL RPM RX1 SAMSI SUPJJ TDBHL TEORI TFW UKHRP V9Y VH1 W8V W99 WBKPD WHWMO WIH WIJ WIK WIN WOHZO WOW WVDHM WXSBR X7M YFH ZGI ZXP ZZTAW ~IA ~WT AAYXX CITATION O8X 33P AAHHS ACCFJ ADZOD AEEZP AEQDE AEUQT AFPWT AIWBW AJBDE CGR CUY CVF ECM EIF ESX NPM K9. 7X8 ADTPV AOWAS D95
ID	FETCH-LOGICAL-c5218-aee2c50651d808839c728d73a1a776969b567d22df60c39cc421d4cc3d47a5353
IEDL.DBID	WIN
ISICitedReferencesCount	85
ISICitedReferencesURI	http://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=Summon&SrcAuth=ProQuest&DestLinkType=CitingArticles&DestApp=WOS_CPL&KeyUT=000399891200013&url=https%3A%2F%2Fcvtisr.summon.serialssolutions.com%2F%23%21%2Fsearch%3Fho%3Df%26include.ft.matches%3Dt%26l%3Dnull%26q%3D
ISSN	0001-6349
IngestDate	Tue Nov 25 03:34:05 EST 2025 Thu Nov 27 03:11:42 EST 2025 Sat Sep 27 22:02:04 EDT 2025 Sat Nov 29 14:35:52 EST 2025 Wed Feb 19 01:57:05 EST 2025 Tue Nov 18 21:42:01 EST 2025 Sat Nov 29 06:00:18 EST 2025 Sun Sep 21 06:20:18 EDT 2025
IsDoiOpenAccess	false
IsOpenAccess	true
IsPeerReviewed	true
IsScholarly	true
Issue	5
Keywords	Robson classification delivery induction of labor uterine scar Cesarean section
Language	English
License	2017 Nordic Federation of Societies of Obstetrics and Gynecology.
LinkModel	DirectLink
MergedId	FETCHMERGED-LOGICAL-c5218-aee2c50651d808839c728d73a1a776969b567d22df60c39cc421d4cc3d47a5353
Notes	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 14 ObjectType-Article-2 ObjectType-Feature-1 content type line 23
ORCID	0000-0001-8254-7525 0000-0001-9352-0125 0000-0001-9968-6660 0000-0001-5765-2630 0000-0003-0503-1319
OpenAccessLink	https://obgyn.onlinelibrary.wiley.com/doi/pdfdirect/10.1111/aogs.13108
PMID	28176334
PQID	1889939615
PQPubID	1136361
PageCount	10
ParticipantIDs	swepub_primary_oai_swepub_ki_se_499226 swepub_primary_oai_portal_research_lu_se_publications_922a9539_de62_48b2_a418_036d35982c24 proquest_miscellaneous_1866294748 proquest_journals_1889939615 pubmed_primary_28176334 crossref_primary_10_1111_aogs_13108 crossref_citationtrail_10_1111_aogs_13108 wiley_primary_10_1111_aogs_13108_AOGS13108
PublicationCentury	2000
PublicationDate	May 2017
PublicationDateYYYYMMDD	2017-05-01
PublicationDate_xml	– month: 05 year: 2017 text: May 2017
PublicationDecade	2010
PublicationPlace	United States
PublicationPlace_xml	– name: United States – name: Reykjavik
PublicationTitle	Acta obstetricia et gynecologica Scandinavica
PublicationTitleAlternate	Acta Obstet Gynecol Scand
PublicationYear	2017
Publisher	John Wiley & Sons, Inc
Publisher_xml	– name: John Wiley & Sons, Inc
References	2015; 12 2012; 91 2015; 3 2013; 27 2015; 51 1985; 2 2015; 122 2015; 189 2016; 123 2009; 201 2016 2001; 15 2015 2014 2013 2014; 9 2001; 12 2011; 6 2009; 49 2011; 154 2016; 11 e_1_2_7_5_1 e_1_2_7_4_1 e_1_2_7_3_1 e_1_2_7_9_1 e_1_2_7_8_1 Bjarnadottir R (e_1_2_7_11_1) 2012; 91 e_1_2_7_7_1 e_1_2_7_19_1 e_1_2_7_18_1 (e_1_2_7_6_1) 1985; 2 e_1_2_7_17_1 e_1_2_7_16_1 e_1_2_7_15_1 e_1_2_7_14_1 e_1_2_7_13_1 e_1_2_7_12_1 e_1_2_7_10_1 Bartels PD (e_1_2_7_26_1) 2016 Heino A (e_1_2_7_2_1) 2016 e_1_2_7_25_1 e_1_2_7_24_1 e_1_2_7_23_1 e_1_2_7_22_1 e_1_2_7_21_1 e_1_2_7_20_1
References_xml	– volume: 15 start-page: 179 year: 2001 end-page: 94 article-title: Can we reduce the caesarean section rate? publication-title: Best Pract Res Clin Obstet Gynaecol – volume: 3 start-page: e260 year: 2015 end-page: 70 article-title: Use of the Robson classification to assess caesarean section trends in 21 countries: a secondary analysis of two WHO multicountry surveys publication-title: Lancet Glob Health – volume: 27 start-page: 297 year: 2013 end-page: 308 article-title: Methods of achieving and maintaining an appropriate caesarean section rate publication-title: Best Pract Res Clin Obstet Gynaecol – volume: 9 start-page: e97769 year: 2014 article-title: A systematic review of the Robson Classification for caesarean section: what works, doesn't work and how to improve it publication-title: PLoS ONE – volume: 12 start-page: 23 year: 2001 end-page: 39 article-title: Classification of caesarean sections publication-title: Fetal Matern Med Rev – volume: 91 start-page: 12 issue: Suppl. 159 year: 2012 end-page: 149 article-title: Poster session abstracts publication-title: Acta Obstet Gynecol Scand – volume: 123 start-page: 559 year: 2016 end-page: 68 article-title: Wide differences in mode of delivery within Europe: risk‐stratified analyses of aggregated routine data from the Euro‐Peristat study publication-title: BJOG – volume: 49 start-page: 606 year: 2009 end-page: 11 article-title: Trends and determinants of caesarean sections births in Queensland, 1997–2006 publication-title: Aust N Z J Obstet Gynaecol – volume: 154 start-page: 136 year: 2011 end-page: 40 article-title: Medical audit using the Ten Group Classification System and its impact on the cesarean section rate publication-title: Eur J Obstet Gynecol Reprod Biol – start-page: 10 year: 2016 end-page: 32 – volume: 123 start-page: 427 year: 2016 end-page: 36 article-title: A global reference for caesarean section rates (C‐Model): a multicountry cross‐sectional study publication-title: BJOG – volume: 11 start-page: e0148138 year: 2016 article-title: Caesarean section in Peru: analysis of trends using the Robson classification system publication-title: PLoS ONE – volume: 6 start-page: e14566 year: 2011 article-title: Classifications for cesarean section: a systematic review publication-title: PLoS ONE – volume: 201 start-page: 308 year: 2009 article-title: Comparative analysis of international cesarean delivery rates using 10‐group classification identifies significant variation in spontaneous labor publication-title: Am J Obstet Gynecol – volume: 51 start-page: 280 year: 2015 end-page: 5 article-title: Cesarean section rates in Lithuania using Robson Ten Group Classification System publication-title: Medicina (Kaunas) – volume: 189 start-page: 91 year: 2015 end-page: 5 article-title: Identification of obstetric targets for reducing cesarean section rate using the Robson Ten Group Classification in a tertiary level hospital publication-title: Eur J Obstet Gynecol Reprod Biol – volume: 11 start-page: e0148343 year: 2016 article-title: The Increasing Trend in caesarean section rates: global, regional and national estimates: 1990–2014 publication-title: PLoS ONE – year: 2016 – volume: 2 start-page: 436 year: 1985 end-page: 7 article-title: Appropriate technology for birth publication-title: Lancet – year: 2014 – year: 2015 – volume: 12 start-page: 1 year: 2015 end-page: 10 article-title: What is the optimal rate of caesarean section at population level? A systematic review of ecologic studies publication-title: Reprod Health – year: 2013 – volume: 122 start-page: 690 year: 2015 end-page: 9 article-title: Stabilising the caesarean rate: which target population? publication-title: BJOG – ident: e_1_2_7_20_1 doi: 10.1016/j.ajog.2009.06.021 – ident: e_1_2_7_12_1 doi: 10.1016/j.ejogrb.2010.09.005 – ident: e_1_2_7_24_1 doi: 10.1016/j.medici.2015.09.001 – ident: e_1_2_7_14_1 doi: 10.1371/journal.pone.0014566 – ident: e_1_2_7_8_1 doi: 10.1017/S0965539501000122 – ident: e_1_2_7_15_1 doi: 10.6027/Nord2014-001 – volume: 91 start-page: 12 issue: 159 year: 2012 ident: e_1_2_7_11_1 article-title: Poster session abstracts publication-title: Acta Obstet Gynecol Scand – ident: e_1_2_7_21_1 doi: 10.1111/1471-0528.13199 – ident: e_1_2_7_22_1 doi: 10.1016/j.ejogrb.2015.03.030 – volume-title: Perinatal Statistics in the Nordic Countries 2014 year: 2016 ident: e_1_2_7_2_1 – ident: e_1_2_7_19_1 doi: 10.1371/journal.pone.0148138 – ident: e_1_2_7_16_1 doi: 10.1787/health_glance-2013-en – ident: e_1_2_7_7_1 – ident: e_1_2_7_9_1 doi: 10.1186/s12978-015-0043-6 – ident: e_1_2_7_10_1 doi: 10.1111/1471-0528.13509 – ident: e_1_2_7_25_1 doi: 10.1016/j.bpobgyn.2012.09.004 – ident: e_1_2_7_5_1 – ident: e_1_2_7_18_1 doi: 10.1053/beog.2000.0156 – ident: e_1_2_7_3_1 doi: 10.1111/1471-0528.13284 – ident: e_1_2_7_4_1 doi: 10.1371/journal.pone.0148343 – ident: e_1_2_7_17_1 doi: 10.1371/journal.pone.0097769 – start-page: 10 volume-title: Working Arbejdsgruppe Under Nordisk Ministerråd om Patientsikkerhed (Group on Patient Safety Under the Nordic Council of Ministers). En Rapport om Patientsikkerhed. Tre Bridag til Styrkelsen af Patientsikkerhed. [A Report on Patient Safety. Three Proposals to Strengthen Patient Safety] year: 2016 ident: e_1_2_7_26_1 – ident: e_1_2_7_23_1 doi: 10.1111/j.1479-828X.2009.01100.x – volume: 2 start-page: 436 year: 1985 ident: e_1_2_7_6_1 article-title: Appropriate technology for birth publication-title: Lancet – ident: e_1_2_7_13_1 doi: 10.1016/S2214-109X(15)70094-X
SSID	ssj0012748
Score	2.4804733
Snippet	Introduction The cesarean rates are low but increasing in most Nordic countries. Using the Robson classification, we analyzed which obstetric groups have... The cesarean rates are low but increasing in most Nordic countries. Using the Robson classification, we analyzed which obstetric groups have contributed to the... Introduction The cesarean rates are low but increasing in most Nordic countries. Using the Robson classification, we analyzed which obstetric groups have... INTRODUCTIONThe cesarean rates are low but increasing in most Nordic countries. Using the Robson classification, we analyzed which obstetric groups have... Introduction: The cesarean rates are low but increasing in most Nordic countries. Using the Robson classification, we analyzed which obstetric groups have...
SourceID	swepub proquest pubmed crossref wiley
SourceType	Open Access Repository Aggregation Database Index Database Enrichment Source Publisher
StartPage	607
SubjectTerms	Cesarean section Cesarean Section - statistics & numerical data Cesarean Section - trends Classification Clinical Medicine Databases, Factual delivery Female Gynaecology, Obstetrics and Reproductive Medicine Gynekologi, obstetrik och reproduktionsmedicin Health risk assessment Humans induction of labor Infant, Newborn Klinisk medicin Maternal Health Services - statistics & numerical data Maternal Health Services - trends Medical and Health Sciences Medicin och hälsovetenskap Physicians Pregnancy Pregnancy Outcome Retrospective Studies Robson classification Scandinavian and Nordic Countries - epidemiology uterine scar
Title	Cesarean section trends in the Nordic Countries – a comparative analysis with the Robson classification
URI	https://onlinelibrary.wiley.com/doi/abs/10.1111%2Faogs.13108 https://www.ncbi.nlm.nih.gov/pubmed/28176334 https://www.proquest.com/docview/1889939615 https://www.proquest.com/docview/1866294748 http://kipublications.ki.se/Default.aspx?queryparsed=id:135693542
Volume	96
WOSCitedRecordID	wos000399891200013&url=https%3A%2F%2Fcvtisr.summon.serialssolutions.com%2F%23%21%2Fsearch%3Fho%3Df%26include.ft.matches%3Dt%26l%3Dnull%26q%3D
hasFullText	1
inHoldings	1
isFullTextHit
isPrint
journalDatabaseRights	– providerCode: PRVAWR databaseName: Taylor & Francis Journals Complete customDbUrl: eissn: 1600-0412 dateEnd: 99991231 omitProxy: false ssIdentifier: ssj0012748 issn: 0001-6349 databaseCode: TFW dateStart: 19220101 isFulltext: true titleUrlDefault: https://www.tandfonline.com providerName: Taylor & Francis – providerCode: PRVWIB databaseName: Wiley Online Library customDbUrl: eissn: 1600-0412 dateEnd: 99991231 omitProxy: false ssIdentifier: ssj0012748 issn: 0001-6349 databaseCode: WIN dateStart: 19970101 isFulltext: true titleUrlDefault: https://onlinelibrary.wiley.com providerName: Wiley-Blackwell – providerCode: PRVWIB databaseName: Wiley Online Library Full Collection 2020 customDbUrl: eissn: 1600-0412 dateEnd: 99991231 omitProxy: false ssIdentifier: ssj0012748 issn: 0001-6349 databaseCode: DRFUL dateStart: 19970101 isFulltext: true titleUrlDefault: https://onlinelibrary.wiley.com providerName: Wiley-Blackwell
link	http://cvtisr.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwpV1faxQxEB9qFfHF_9rVekQUQWGlm2SzG_ClVE8FPaVaPHwJ2SRnl5a90r3z2e_gN_STOJPd27ZYBPFt2UyySzKT_CaZ_AbgcYlLMq9kliJUdqnMvUorN-MptzqoiuiHuI_JJorJpJxO9cc1eLG6C9PxQwwbbmQZcb4mA7dVe8rI7fxb-zxDdEI3fTOZUfqCL28nwxECulvdNIz-shJS99ykFMZzUvXsavQHxBz4Q89C17j2jK_9319fh6s95mTbnZLcgLXQ3ITL7_tT9VtQ74TWInhsWBsDsxq2iJGyrMan_cAm6KDWjtH1dUq_1bJfP34yy9wJcTizPbcJo33dWGl3TpnJmSN0TuFIUQNuw9741eedN2mfgiF1uK6XqQ2BuxxhSuZLnI-EdgUvfSFsZotCaaWrXBWecz9TWw5LneSZl84JLwubi1zcgfVm3oQNYEKKgHAIAc8sIIrYqpxFMDlz2tMpT1El8HQ1FMb1_OSUJuPQrPwU6jsT-y6BR4PsUcfKca7U5mpETW-ZWFKihyk0ArkEHg7FaFN0UGKbMF-SjFJcS1SgBO52mjB8BtUXp2QhE_jaqcZQQkTdnc9keqKmfXO4NG0wR6d2YI3maAe50MYHxY0sK26szEqDUMJHOkXHsfEn5zTevzqoqU1JhMIqgWdR2_7SC2b7w-tP8enevwjfhyucEEyM7dyE9cXxMjyAS-77om6PR3ChmJYjuPhyd7z3bhQN7ze45i_0
linkProvider	Wiley-Blackwell
linkToHtml	http://cvtisr.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwpV3LbtUwEB1BQZQN70eggBEICaSgxnaceFlVlFa0AUERFRvLsX3biCq3au5lzT_wh3wJM05u2ooKCbGL4kcie8Y-Mx6fAXhe4pbMa5mlCJVdKnOv0tpNeMqtDqom-iHuY7KJoqrKvT39YYjNobswPT_E6HAjzYjrNSk4OaRPabmd7nevM4Qn5UW4JBFpUOaGL1vVeIiABle_EKPFrITUAzspBfKctD27H_0BMkcG0bPgNe4-G9f_879vwLUBdrK1Xk5uwoXQ3oIrO8PB-m1o1kNnET-2rIuxWS2bxWBZ1uDTQWAV2qiNY3SDnTJwdezXj5_MMnfCHc7sQG_CyLUbG32cUnJy5gigU0RSFII78Hnjze76ZjpkYUgdbu1lakPgLkekkvkSlyShXcFLXwib2aJQWuk6V4Xn3E_UqsNSJ3nmpXPCy8LmIhd3YamdtuE-MCFFQESEmGcSEEis1s4inpw47emgp6gTeLmYC-MGinLKlHFoFqYKjZ2JY5fAs7HuUU_McW6tlcWUmkE5saREI1NoxHIJPB2LUa3orMS2YTqnOkpxLVGCErjXi8L4GZRgXJWFTOBrLxtjCXF192aTGbiaDszh3HTBHJ1ywhrNURVyoY0PihtZ1txYmZUG0YSPjIqOY-cvzul8ePWtoT4lcQqrBF5FcfvLKJi1928_xacH_1L5CSxv7u5sm-2t6t1DuMoJ0MRQzxVYmh3PwyO47L7Pmu74cdS73-T8MYo
linkToPdf	http://cvtisr.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwpV3NbtQwEB7BFlW98P8TKGAEQgIpqLEdJz5WLQuIslSFSlUvlmM7bUSVXTW7nHkH3pAnYex401ZUSIhbFI-dyJ6xv7HH3wC8KHFJphXPUoTKJuW5FWllappSLZ2oPP0QtSHZRDGZlAcHcjfG5vi7MD0_xLDh5i0jzNfewN3M1uesXE-PujcZwpPyKqxwn0VmBCvbe-P9neEYAV2ufipGn1kwLiM_qQ_lOat9cUX6A2YOHKIX4WtYf8Y3_vPPb8L1CDzJZq8pt-CKa2_D6qd4tH4Hmi3XaUSQLelCdFZL5iFcljT4dOzIBL3UxhB_h93n4OrIrx8_iSbmjD2c6EhwQvzmbqi0N_XpyYnxEN3HJAU1uAv747dft96nMQ9DanBxL1PtHDU5YpXMljgpMWkKWtqC6UwXhZBCVrkoLKW2FhsGSw2nmeXGMMsLnbOc3YNRO23dAyCMM4eYCFFP7RBKbFRGI6KsjbT-qKeoEni1HAtlIkm5z5VxopbOiu87FfougeeD7Kyn5rhUan05pCqaJ5aU6GYyiWgugWdDMRqWPy3RrZsuvIwQVHLUoATu96owfAZ1GOdlxhM47HVjKPFs3b3jpCJb07E6WajOqdm5bVglKRpDzqSyTlDFy4oqzbNSIZ6wgVPRUGz85SWNx1ffGt8m96zCIoHXQd3-0gtq8_O7L-Hp4b8IP4XV3e2x2vkw-fgI1qhHNCHWcx1G89OFewzXzPd5050-iYb3G_MgMjM
openUrl	ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=Cesarean+section+trends+in+the+Nordic+Countries+%E2%80%93+a+comparative+analysis+with+the+Robson+classification&rft.jtitle=Acta+obstetricia+et+gynecologica+Scandinavica&rft.au=Pyyk%C3%B6nen%2C+Aura&rft.au=Gissler%2C+Mika&rft.au=L%C3%B8kkegaard%2C+Ellen&rft.au=Bergholt%2C+Thomas&rft.date=2017-05-01&rft.issn=0001-6349&rft.eissn=1600-0412&rft.volume=96&rft.issue=5&rft.spage=607&rft.epage=616&rft_id=info:doi/10.1111%2Faogs.13108&rft.externalDBID=n%2Fa&rft.externalDocID=10_1111_aogs_13108
thumbnail_l	http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/lc.gif&issn=0001-6349&client=summon
thumbnail_m	http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/mc.gif&issn=0001-6349&client=summon
thumbnail_s	http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/sc.gif&issn=0001-6349&client=summon