Prevalence of and Factors Associated with Cesarean Delivery in Kigali, Rwanda: A Hospital-Based Cross-Sectional Study

BACKGROUND: Cesarean delivery is rising globally, and Sub-Saharan Africa is no exception. AIM: This study investigated the prevalence and factors associated with cesarean delivery in Kigali, Rwanda. METHODS: This hospital-based cross-sectional study was carried out in two hospitals in Kigali, Rwanda. A questionnaire was used to collect sociodemographic and obstetrical data, including mode of delivery. Weight, height, and hemoglobin level were measured using standard procedures. Multivariate binary analysis was performed. RESULTS: In this study, 445 pregnant women were included. The median (interquartile [IQR]) age and parity were 30.0 (26.0‒35.0) years and 1.0 (0.0‒3.0), respectively. One hundred and eleven (24.9%) women were delivered via cesarean, of whom 66 (59.5%) were delivered via emergency cesarean and the remaining 45 (40.5%) via elective cesarean. In multivariate logistic regression, maternal age (adjusted odds ratio [AOR] = 1.11, 95% confidence interval [CI] 1.05‒1.16), having a husband with educational attainment of secondary or less (AOR = 1.73, 95% 1.08‒2.80), and a history of miscarriage (AOR = 3.77, 95% CI 2.02‒7.03) were significantly associated with cesarean delivery. There was no significant association between cesarean delivery and parity, anemia, or low birth weight. CONCLUSION: One out of four pregnant women in Kigali was delivered via cesarean regardless of their parity. Age and history of miscarriage can be used as a predictor for cesarean delivery in Rwanda. Additional socio-epidemiological research is recommended to explore the impact of increasing maternal age without an increase in parity and low educational levels among husbands on the mode of delivery in Rwanda.