Maternal and obstetric determinants of cesarean section delivery among mothers in public hospitals of Burao, Somaliland: an unmatched case–control study
Year: 2026
Type: article
Study design: Observational Study
Abstract: Cesarean section (CS) is a critical obstetric intervention that reduces maternal and neonatal morbidity and mortality when medically indicated. However, the increasing rate of cesarean delivery has become a major public health concern worldwide, particularly in low- and middle-income countries. Evidence regarding the determinants of cesarean section delivery in Somaliland remains limited. Therefore, this study aimed to identify maternal and obstetric determinants of cesarean section delivery among women delivering in public hospitals of Burao, Somaliland. An institution-based unmatched case-control study was conducted from April 15 to May 15, 2026, among 246 women (82 cases and 164 controls) who delivered in Burao General Hospital and Al-Khalifa Hospital. Cases were women who delivered by cesarean section, while controls were women who delivered vaginally. Data were collected using a structured interviewer-administered questionnaire and medical record review through KoboToolbox. Data were analyzed using SPSS version 27. Bivariable and multivariable logistic regression analyses were performed to identify factors associated with cesarean section delivery. Adjusted odds ratios (AORs) with 95% confidence intervals (CIs) were used to measure associations, and statistical significance was declared at p < 0.05. Previous history of cesarean section, non-cephalic fetal presentation, prolonged labor duration, and pregnancy-related complications were independently associated with cesarean section delivery. Women with a previous history of cesarean section were approximately nineteen times more likely to undergo cesarean delivery than those without a previous cesarean section (AOR = 19.35, 95% CI: 7.98–46.93). Mothers with non-cephalic fetal presentation were four times more likely to deliver by cesarean section compared with those with cephalic presentation (AOR = 4.05, 95% CI: 1.61–10.20). Women who experienced prolonged labor (≥ 12 h) were nearly nine times more likely to undergo cesarean section delivery than those with shorter labor duration (AOR = 8.92, 95% CI: 3.10–25.63). Similarly, women with pregnancy-related complications were approximately twelve times more likely to deliver by cesarean section than those without complications (AOR = 11.59, 95% CI: 4.60–29.18). Previous cesarean section, non-cephalic fetal presentation, prolonged labor duration, and pregnancy-related complications were significant determinants of cesarean section delivery among women in public hospitals of Burao, Somaliland. Strengthening antenatal care services, improving labor monitoring, promoting early detection and management of pregnancy complications, and ensuring timely referral of high-risk pregnancies may contribute to appropriate utilization of cesarean section and improved maternal and neonatal outcomes.
Source: Reproductive Health
Institution: Burao University
Language: English
Subfield: Obstetrics and Gynecology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,290
OpenAlex ID: W7204096750
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