Trend of incompleteness of the Robson Classification variables in the Live Birth Information (SINASC) in the state of Paraná, Brazil, 2014-2020

Falavina, Larissa Pereira; Fujimori, Elizabeth; Lentsck, Maicon Henrique

doi:10.1590/S2237-96222024V33E2023632.EN

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Epidemiologia e Serviços de Saúde

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RESEACH NOTE • Epidemiol. Serv. Saúde 33 • 2024 • https://doi.org/10.1590/S2237-96222024V33E2023632.EN copy

Trend of incompleteness of the Robson Classification variables in the Live Birth Information (SINASC) in the state of Paraná, Brazil, 2014-2020

Tendencia de incompletitud de variables de Clasificación de Robson en el Sistema de Información de Nacidos Vivos en Paraná, 2014-2020

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

To assess the incompleteness of the Robson Classification variables in the Live Birth Information System (Sistema de Informação sobre Nascidos Vivos - SINASC), in the state of Paraná, and its trend, 2014-2020.

Methods:

This was a time-series study that analyzed six variables, according to health macro-regions. Incompleteness was classified (percentage of “ignored” and “blank fields”) as follows: excellent (< 1.0%); good (1.0-2.9%); regular (3.0-6.9%); poor (≥ 7.0%). Prais-Winsten regression was used to estimate trends.

Results:

A total of 1,089,116 births were evaluated. The variable “cesarean section before the onset of labor” was classified as poor in 2014 (39.4%) and 2015 (44.3%) in the state and in all macro-regions, but with a decreasing trend in incompleteness. The variables “gestational age” in the North and Northwest macro-regions, and “parity” and “number of fetuses” in the Northwest macro-region showed an increasing trend.

Conclusion:

Most of the variables evaluated showed low percentages of incompleteness with a decreasing trend, but there is a need to improve the completion of some variables.

Keywords:
Cesarean Section; Health Information Systems; Descriptive Epidemiology; Vital Statistics

Characteristics used in the Robson Classification	Definition	Variable designations in SINASC
Onset of labor^a	Spontaneous, induced or cesarean section before the onset of labor.	STTRABPART = Was labor induced? STCESPARTO = did cesarean section occur before the onset of labor?
Fetal presentation	Position of the fetus in the womb: cephalic, breech or transverse.	TPAPRESENT = Type of fetal presentation.
Parity	Nulliparous: has never given birth. Multiparous: has given birth at least once.	QTDPARTNOR = Number of previous vaginal deliveries. QTDPARTCES = Number of previous caesarean sections.
Gestational age	Corresponds to the gestational age at birth.	SEMAGESTAC = Number of weeks of gestation.
Number of fetuses	Corresponds to the number of fetuses in that pregnancy: single, twins, triplets or more.	GRAVIDEZ = Type of pregnancy.

Macro-regions/Variables	2014	2015	2016	2017	2018	2019	2020
East
Cesarean section before the onset of labor.	47.6	53.6	8.2	8.5	5.9	7.2	10.0
Induced labor	11.8	11.7	7.1	8.3	6.7	5.8	6.9
Fetal presentation	3.0	2.3	1.4	1.3	0.6	0.6	1.0
Parity	0.8	0.6	0.8	0.2	0.3	0.3	0.5
Gestational age	1.5	1.2	1.0	1.0	0.5	0.6	0.8
Number of fetuses	0.1	0.1	0.2	0.1	0.1	0.1	0.1
West
Cesarean section before the onset of labor.	34.7	37.2	2.0	2.4	3.1	2.0	1.6
Induced labor	4.2	3.9	4.0	4.0	3.3	3.8	3.5
Fetal presentation	3.2	3.6	3.1	1.4	0.2	0.4	0.3
Parity	0.1	0.2	0.1	0.7	0.1	0.2	0.2
Gestational age	0.5	0.6	1.7	0.6	0.3	0.4	0.5
Number of fetuses	0.1	0.1	0.1	0.1	0.1	-	0.1
North
Cesarean section before the onset of labor	31.4	34.3	2.8	3.1	2.8	3.8	4.6
Induced labor	1.1	1.4	1.6	3.1	2.4	1.4	1.4
Fetal presentation	1.1	1.2	1.2	1.5	0.9	0.6	0.7
Parity	2.7	3.5	3.4	1.1	0.8	0.4	0.4
Gestational age	0.4	1.2	1.0	1.2	1.1	1.3	1.3
Number of fetuses	0.1	0.1	0.1	0.1	0.1	0.1	0.1
Northwest
Cesarean section before the onset of labor	24.9	32.8	4.7	2.3	1.5	1.8	1.4
Induced labor	0.2	0.7	0.6	0.9	0.5	0.5	0.6
Fetal presentation	0.6	0.8	0.7	0.3	0.5	0.4	0.4
Parity	0.1	0.1	-	0.1	2.7	0.3	1.1
Gestational age	0.2	0.4	0.3	0.4	0.4	0.5	0.5
Number of fetuses	-	0.1	0.1	0.1	0.1	0.1	0.1
Paraná state
Cesarean section before the onset of labor	39.4	44.3	5.6	5.5	4.2	4.7	6.1
Induced labor	7.0	6.9	4.6	5.4	4.4	3.8	4.3
Fetal presentation	2.3	2.1	1.6	1.2	0.6	0.5	0.7
Parity	0.9	0.9	1.0	0.4	0.7	0.3	0.5
Gestational age	0.9	0.9	1.0	0.9	0.5	0.7	0.8
Number of fetuses	0.1	0.1	0.1	0.1	0.1	0.1	0.1

Variables	Annual change^a	_95% CI ^b	Trend
Cesarean section before the onset of labor
East	-27.5	-44.3;-5.7	Decreasing
West	-41,7	-56.0;-22.7	Decreasing
North	-25.5	-42.8;-2.9	Decreasing
Northwest	-42.0	-55.5;-24.5	Decreasing
Paraná state	-32,3	-48.8;-10.8	Decreasing
Induced labor
East	-10.0	-13.6;-6.3	Decreasing
West	-2.3	-3.1;-1.5	Decreasing
North	-10.4	-14.0;44.7	Stable
Northwest	2.3	-7.7;13.5	Stable
Paraná state	-6.0	-6.7;-5.2	Decreasing
Fetal presentation
East	-19.0	-26.8;-10.4	Decreasing
West	-35.0	-45.7;-22.1	Decreasing
North	-1.3	-19.8;21.5	Satable
Northwest	-10.4	-14.3;-6.3	Decreasing
Paraná state	-20.4	-26.6;-13.7	Decreasing
Parity
East	-13.5	-22.3;-3.8	Decreasing
West	5.3	-15.4;31.1	Stable
North	-24.8	-40.6;-4.9	Decreasing
Northwest	63.0	7.7;146.7	Increasing
Paraná state	-8,8	-19.5;3.2	Stable
Gestational age
East	-1.9	-20.2;1.9	Decreasing
West	-5.9	-30.2;26.8	Stable
North	12.9	3.8;22.8	Increasing
Northwest	11.4	8.9;13.9	Increasing
Paraná state	-0.1	-5.9;6.0	Stable
Number of fetuses
East	2.8	-10.7;18.3	Stable
West	-5,4	-10.1;-0.5	Decreasing
North	8.0	-1.2;18.2	Stable
Northwest	3.1	1.7;4.5	Increasing
Paraná state	2.1	-4.9;9.6	Stable

Secretaria de Vigilância em Saúde e Ambiente - Ministério da Saúde do Brasil SRTVN Quadra 701, Via W5 Norte, Lote D, Edifício P0700, CEP: 70719-040, +55 61 3315-3464, Fax: +55 61 3315-3464 - Brasília - DF - Brazil
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[1] Corresponding author:
Larissa Pereira Falavina.
Email:
larissafalavina@usp.br