Association Between Adequate Antenatal Care Visits and Caesarean Section Delivery Among Women in Bangladesh: A Cross-Sectional Study Using BDHS 2022 Data

Sammanfattning

Abstract Caesarean section (CS) rates have increased substantially in Bangladesh, raising concerns about potential overuse. Antenatal care (ANC) is a key component of maternal healthcare, but its relationship with CS delivery remains complex and context-dependent. This study aimed to examine the association between adequate ANC visits and CS delivery among women in Bangladesh. A cross-sectional study was conducted using data from the Bangladesh Demographic and Health Survey (BDHS) 2022. The analytical sample included 3,613 women aged 15–49 years who had a singleton live birth within two years preceding the survey and complete information on ANC visits and mode of delivery. Adequate ANC was defined as ≥4 visits. Descriptive statistics, chi-square tests, and logistic regression analyses were performed. Multivariable logistic regression adjusted for maternal age, education, wealth index, and place of residence. Sensitivity analyses were conducted using an alternative definition of ANC (≥8 visits) and by assessing the impact of missing data. Overall, 41.4% of women received adequate ANC, and 45.3% delivered by CS. Women with adequate ANC had higher odds of CS delivery in both crude (OR = 2.81, 95% CI: 2.45–3.22) and adjusted analyses (aOR = 1.88, 95% CI: 1.62–2.18). The association remained significant in sensitivity analyses, suggesting robust findings. Adequate ANC visits are significantly associated with a higher likelihood of CS delivery in Bangladesh. This association likely reflects increased interaction with the healthcare system and broader patterns of medicalisation. These findings highlight the importance of monitoring CS practices alongside efforts to improve maternal healthcare utilisation in Bangladesh.