Correlation of Cesarean rates to maternal and infant mortality rates: an ecologic study of official international data
Correlation of Cesarean rates to maternal and infant mortality rates: an ecologic study of official international data
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DOI：
10.1590/s1020-49892011000500001
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发表时间：
2011-05-01
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影响因子：
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通讯作者：
Volpe, Fernando Madalena
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文献类型：
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作者：
Volpe, Fernando Madalena
Objective.将国际官方数据与剖腹产率、婴儿和产妇死亡率以及出生时低体重相关;并检验剖腹产率大于15%与较高的产妇和婴儿死亡率相关的假设。分析依据的是193个国家的最新官方数据（2000-2009年）。将指数模型与二次模型进行比较，以回归婴儿死亡率、新生儿死亡率、孕产妇死亡率和出生时低体重率与剖腹产率。对剖腹产率大于15%的国家进行了单独的回归。结果。在剖腹产率低于15%的国家，较高的剖腹产率与较低的婴儿、新生儿和孕产妇死亡率以及较低的出生体重相关。在剖腹产率大于15%的国家，剖腹产率与婴儿或孕产妇死亡率没有显著相关性。各国的剖腹产率与婴儿或产妇死亡率之间呈指数反比关系。非常低的剖腹产率（低于15%）与较差的孕产妇和儿童结局相关。剖腹产率高于15%与较高的孕产妇或儿童死亡率无关，也与出生时体重低无关。
Objective. To correlate international official data on Cesarean delivery rates to infant and maternal mortality rates and low weight-at-birth rates; and to test the hypothesis that Cesarean rates greater than 15% correlate to higher maternal and infant mortality rates.Methods. Analyses were based on the most recent official data (2000-2009) available for 193 countries. Exponential models were compared to quadratic models to regress infant mortality rates, neonatal mortality rates, maternal mortality rates, and low weight-at-birth rates to Cesarean rates. Separate regressions were performed for countries with Cesarean rates greater than 15%.Results. In countries with Cesarean rates less than 15%, higher Cesarean rates were associated to lower infant, neonatal, and maternal mortality rates, and to lower rates of low weight-at-birth. In countries with Cesarean rates greater than 15%, Cesarean rates were not significantly associated with infant or maternal mortality rates.Conclusions. There is an inverse exponential relation between countries' rates of Cesarean deliveries and infant or maternal mortality rates. Very low Cesarean rates (less than 15%) are associated with poorer maternal and child outcomes. Cesarean rates greater than 15% were neither correlated to higher maternal nor child mortality, nor to low weight-at-birth.