Cut down on the prevalence of cesarean sections in Brazil: a time-series from 2000 to 2017

Cesarean section was developed to reduce maternal-fetal morbidity and mortality, however when performed without scientific evidence it is associated with complications. This study analyses the temporal trend and factors associated with cesarean section in Brazil, its regions and Federation Units between 2000 and 2017. Ecological study. The prevalence of cesarean sections and maternal variables were identified from the Information System on Live Births. The Prais-Winsten method was used for time series analysis. In the whole period there were 53.497.303 births in Brazil, 48.4% by cesarean section. Between 2000 and 2009, the mean cesarean section in Brazil increased from 39.7% (SD 9.8) to 53% (SD 9.4) between 2010 and 2017 with an annual variation of 1.7 p.p (95%CI 1.6; 1.8). There is stability between 2010 and 2017, with a slight decline from 2015 in the Southeast region with an annual variation of -0.9 (95%CI -1.5; 0.0). It is observed that the caesarean section has remained stable in most macro-regions and even decreasing in the southeast and in the group of women with higher education, not adolescents and better prenatal coverage. It is believed that Brazil has reached the plateau in the prevalence of cesarean section (60%) in most states and in the next years there is a decrease in these prevalences.