Factors associated with actual mode of delivery among women attending antenatal education at a university hospital in Türkiye: a retrospective observational study
Year: 2026
Type: article
Study design: Observational Study
Abstract: ABSTRACT: OBJECTIVES: To determine the maternal, obstetric and antenatal education-related factors associated with actual mode of delivery among women attending an open-group antenatal education programme. DESIGN: Retrospective observational study. SETTING: Antenatal outpatient clinic of a university hospital in Ankara, Türkiye. Data were retrospectively obtained from the hospital information management system and delivery records. PARTICIPANTS: The source population comprised 1418 women who attended antenatal education between July 2024 and July 2025. Delivery outcome data were available for 641 women, who constituted the analytic sample for mode-of-delivery analyses. As of 31 July 2025, when the data were extracted, 530 women had ongoing pregnancies and 247 had passed their estimated delivery date but had no delivery outcome recorded in the hospital system. Because previous caesarean section resulted in quasicomplete separation, the primary multivariable analysis was restricted to 494 women without a history of previous caesarean section. PRIMARY AND SECONDARY OUTCOME MEASURES: The primary outcome was actual mode of delivery, categorised as vaginal or caesarean delivery. The main explanatory variables were maternal age, parity, gestational week at first educational attendance, pre-education preferred mode of delivery and attendance at each of the four antenatal education sessions. Caesarean indications were additionally summarised descriptively. RESULTS: Among the 641 women with available delivery outcomes, 390 (60.8%) had a vaginal delivery and 251 (39.2%) underwent caesarean section. In the primary multivariable analysis among women without a previous caesarean section (n=494), increasing maternal age was associated with higher odds of caesarean delivery (adjusted OR (aOR) 1.114, 95% CI 1.056 to 1.176; p<0.001), whereas multiparity was associated with lower odds (aOR 0.117, 95% CI 0.063 to 0.217; p<0.001). An exploratory association was also observed for session 4 attendance (aOR 0.453, 95% CI 0.253 to 0.811; p=0.008). Gestational week at first educational attendance, pre-education preferred mode of delivery and attendance at sessions 1–3 were not independently associated with mode of delivery. CONCLUSIONS: Among women without a history of previous caesarean section, maternal age and parity were independently associated with actual mode of delivery, whereas pre-education delivery preference was not. An exploratory association was observed for session 4 attendance, but this finding should be interpreted cautiously because attendance was non-random and occurred later in pregnancy.
Source: BMJ Open
Institution: Ankara University
Language: English
Subfield: Obstetrics and Gynecology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $1,839
OpenAlex ID: W7223249903