Photo Credit: Nadzeya Haroshka

The following is a summary of “Variations in caesarean section outcome reporting in low- and middle-income countries: A systematic review,” published in the January 2025 issue of Obstetrics and Gynecology by Wilson et al.

This study aimed to evaluate the variation and quality of outcomes reported in comparative studies addressing cesarean section complications in low- and middle-income countries by employing descriptive analysis and interactive network visualizations. A systematic review was conducted on studies that assessed interventions aimed at reducing maternal and perinatal complications following cesarean section. The quality of the reported outcomes was evaluated using the modified Harman questionnaire, which examined the presence of a clear primary outcome, the methods used to analyze outcomes, and the measures taken to enhance outcome reporting quality. A total of 102 comparative studies were included in the review, reporting 466 outcomes. Notably, 15% of these outcomes appeared only once across the studies (n = 73). 

The most frequently reported outcome categories included maternal death, disability, and bleeding, while psychological and injury-related outcomes were less commonly addressed. The quality of outcome reporting varied significantly across the studies, with many studies providing limited details about the methodologies used to improve the robustness of the reported outcomes. When assessed using the modified Harman score, only 16% of primary outcomes and 11% of secondary outcomes achieved the maximum score of 3 points, with a median score of 2 for all outcomes (range: 0–3). Factors influencing the quality of reporting included the nature of the outcome (primary or secondary), the region in which the study was conducted, and journal characteristics such as impact factor and type. The findings highlight significant variability in both the types and frequencies of outcomes reported in cesarean section-related studies. The generally low quality of outcome reporting, especially regarding the methods employed to improve outcome measures, underscores the need for a core outcome set in cesarean section intervention trials. This would ensure greater consistency and synergy in defining, measuring, and synthesizing outcomes in future research in low- and middle-income countries, ultimately improving the quality of evidence in this critical area.

Source: sciencedirect.com/science/article/abs/pii/S0301211525000478