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ObjectiveThis study aimed to investigate trends in the rate of cesarean sections (CSs) in South Korea from 2006 to 2015 andidentify the risk factors associated with these changes. MethodsUsing the National Health Insurance Corporation dataset, all women who gave birth between 2006 and 2015 wereincluded in the study. We investigated 1) the mode of delivery, 2) the complication rates during pregnancy (i.e.,preeclampsia and placenta previa), and 3) pre-pregnancy factors (body mass index, hypertension [HTN], diabetesmellitus [DM], and other pre-existing medical conditions), and their trends during the study period. ResultsOver 10 years, the rate of CS increased from 36.3% in 2006 to 40.6% in 2015 (P<0.01). The rate of CS increasedin primiparous women, women with multiple pregnancy, and women with preeclampsia. Maternal age and theincidence of placenta previa also increased. In contrast, the rate of vacuum deliveries and vaginal birth after CSdecreased during the study period. The rate of women with pre-pregnancy obesity and DM increased, but the rate ofwomen with pre-pregnancy HTN decreased. ConclusionThe rate of CS in South Korea increased from 2006 to 2015. This trend may reflect changes in the rate of different riskfactors. Identifying the causes of the increasing CS trend observed in this study will allow clinicians to monitor thesefactors and possibly reduce the rate of CS.

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