Factors Associated with Cesarean Section in Primiparous Women at the Bernard Kouchner Communal Medical Centre in Coronthie, Conakry, Guinea

<i>Objective</i>: to analyse the factors associated with Caesarean section in primiparous women. <i>Methods</i>: This was a 12-month (1 January to 31 December 2022) retrospective case-control study conducted at the Bernard Kouchner Communal Medical Centre (CMC) in Coronthie. Correctly completed records of primiparous women with a singleton pregnancy were included, with a live foetus in cephalic presentation having been delivered (by Caesarean section or vaginal delivery) from 28 weeks' gestation with a weight ≥ 1000 g. The "cases" consisted of records from primiparous women who had undergone caesarean section. The "controls" were composed by matching each "case" with the record of a patient who had undergone vaginal delivery, according to the order in the delivery register. Socio-demographic, clinical and obstetric characteristics were analysed and compared. A univariate analysis comparing cases to controls and a multivariate analysis looking for an association between maternal determinants were performed. <i>Results</i>: The prevalence of caesarean section in primiparous women was 31%. The average age of primiparous women was 24 ± 5 years. The 20-24 age group was the most represented in both groups, with 35% of caesareans and 42% of vaginal deliveries. The factors significantly associated with caesarean section in primiparous women were advanced maternal age (OR=1.13 CI=1.07-1.20), prolonged pregnancy (OR=25.1 CI =3.23 - 5.40), arterial hypertension (OR=4.98 CI= 2.24 -11.6), premature rupture of membranes (OR= 4.25 CI: 2.27 - 8.05), haemorrhagic complications (OR=8.56 CI=3.05 - 26.6), foetal distress (OR=68.4 CI=18.3 - 45.1) and macrosomia (OR=12.7 CI= 4.83 - 38.6). <i>Conclusion</i>: correct antenatal care and delivery by qualified personnel could help prevent some of these factors and thus reduce the caesarean section rate among primiparous women in our health facility.