Determination of a 12-year trend of cesarean surgery and vaginal delivery in West Azerbaijan Province of Iran and its prediction until 2018

The investigation and prediction of changes in the trend of cesarean and vaginal delivery can play a significant role in awareness and policy-making on health promotion and prevalence and incidence of health problems. Therefore, the aim of this study was to determine the proper time series pattern and trend for the prediction of deliveries in West Azerbaijan province, Iran.

This longitudinal study was conducted during 2004-2013 through monthly recording of the number of vaginal deliveries and cesarean section in West Azarbaijan province. In order to model and forecast the delivery trend in the next 3 years, Box-Jenkins time series approach and its diagnosis and evaluation methods were employed. To fit the appropriate models for trend analysis in both types of deliveries, R and SPSS (version 23) statistical software were used.

According to the delivery data in the province, 37.4% and 62.6% of the deliveries were cesarean sections and vaginal deliveries, respectively, during 12 years. The results of the time series forecasting model predicting the trend of deliveries in the next 3 years showed that the number of caesarean section would decrease by 0.9%, compared to that in 2013, while the vaginal delivery rate would increase by 6.7%.

Based on the results of the time series forecasting model, the rate of cesarean section is on a relatively decreasing trend, compared to that of the vaginal delivery and was estimated as about 37.1%. This is indicative of the actions of the Ministry of Health and Medical Education toward the promotion of vaginal delivery. However, this rate is still far from the WHO standard