Table 2 Effect of the intervention on primary outcome and maternal process-of-care outcomes

From: Effects of the WHO Labour Care Guide on cesarean section in India: a pragmatic, stepped-wedge, cluster-randomized pilot trial

 

Intervention period (N = 14,814 women)

Control period (N = 11,517 women)

RR (95% CI)e

n/N

(%)

n/N

(%)

 

Primary outcome

     

Cesarean section in Robson Group 1

1,709/4,302

(39.7)

1,602/3,543

(45.2)

0.85 (0.54–1.33)

Maternal process-of-care outcomes

     

Cesarean section in women in Robson Groups 1 and 3

2,012/7,485

(26.9)

1,919/6,204

(30.9)

0.81 (0.59–1.11)

Cesarean section in women in Robson Groups 1, 2, 3, 4 and 5

6,529/12,735

(51.3)

5,028/9,808

(51.3)

0.92 (0.78–1.10)

Cesarean section (all women)

7,505/14,814

(50.7)

5,817/11,517

(50.5)

0.91 (0.71–1.15)

Augmentation with oxytocin during labora

912/9,764

(9.3)

2,273/8,318

(27.3)

0.34 (0.01–15.04)

Artificial rupture of the membranesa,d

553/9,764

(5.7)

559/8,318

(6.7)

-

Episiotomyb

4,820/7,309

(65.9)

3,137/5,700

(55.0)

0.99 (0.73–1.35)

Operative vaginal birthb

192/7,309

(2.63)

112/5,700

(1.96)

1.12 (0.13–9.36)

Days from admission to childbirthc

0.34

(0.73)

0.30

(0.68)

0.05 (−0.31–0.41)

Days from childbirth to dischargec

3.29

(1.75)

3.52

(1.88)

0.23 (−0.84–1.30)

  1. aWomen in spontaneous labor were considered.
  2. bWomen with vaginal deliveries were considered.
  3. cThe mean of the days and standard deviations are reported. The effect size was calculated as the difference between the mean of days in the intervention group and the mean of days in the control group.
  4. dRR was not estimated since convergence of the model was not achieved.
  5. eThe RR and 95% CI were estimated with the generalized estimating equation method employing the Manck and DeRouen bias correction method and a degree of freedom approximation.