Correlation between cesarean section and perinatal mortality rate

Objectives: cesarean section rates show a wide variation among countries, ranging from 0,4-40%, and continuous rise. Our aim was to test hypothesis that higher Cesarean rate than 15% does not correlates with lower perinatal mortality rate.Methods: We analysed 18-year period with high–quality cesarean delivery and perinatal mortality rates information data. Data were analised by Chi-square test with Yate's correction for large values.Results: Cesarean section rates has increasing trend. In first six-years of observed period (1998-2003) mean cesarean section rate was 17,24%, in second (2004-2010) 19,33% and in third (1011-2015) 23,97%. In observed period mean perinatal mortality rate was 9,90‰, with fluctuation of 20,70‰ to 3,82‰. In first six-years of observed period (1998-2003) mean perinatal mortality rate was 13,81‰, in second (2004-2011) 8,28‰ and in third (2011-2015) 7,46‰. These data clearly showed that increase of cesarean section rate more than 19,33% is not correlate with decreasing od perinatal mortality.Conclusion: Despite many suggestions that improvement in perinatal mortality does not necessarily rely upon an ever-increasing cesarean section rate and recommendation by World Health Organisation that cesarean section rate should not exceed 10-15 percent to optimise neonatal outcomes, this recommendation may be too low, and suggests rate of 19%.