Wide differences in mode of delivery within Europe: risk-stratified analyses of aggregated routine data from the Euro-Peristat study
Wide differences in mode of delivery within Europe: risk-stratified analyses of aggregated routine data from the Euro-Peristat study
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DOI：
10.1111/1471-0528.13284
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发表时间：
2016-03-01
影响因子：
5.8
通讯作者：
Zeitlin, J.
中科院分区：
文献类型：
--
作者：
Macfarlane, A. J.;Blondel, B.;Zeitlin, J.
目的使用常规来源的数据比较欧洲整体和干预风险较高的亚组的产科干预率。设计汇总常规数据的回顾性分析。设置31个欧洲国家或地区提供有关分娩方式的数据，Peristat项目，2010年参与国的人口出生率。剖腹产率为指定subgroup.Main结局measurements模式deliver.ResultsRates的剖腹产率范围从14.8%至52.2%的所有出生和率的仪器阴道分娩范围从0.5%至16.4%。总体而言，阴道助产率与剖腹产率之间没有关联，但在一些地理位置接近且可能有共同实践传统的国家之间观察到相似之处。剖腹产率与臀位和头顶分娩的妇女，单胎和多胎，但模式的关联妇女谁和没有以前的剖腹产率之间观察到的协会更为复杂。ConclusionsThe持久广泛的变化，剖腹产和仪器阴道分娩率点缺乏共识的做法，并提出了进一步调查的问题。需要进一步研究，以探讨临床指南，医疗保健系统及其融资以及父母和专业人员对分娩护理的态度差异的影响。
ObjectiveTo use data from routine sources to compare rates of obstetric intervention in Europe both overall and for subgroups at higher risk of intervention.DesignRetrospective analysis of aggregated routine data.SettingThirty-one European countries or regions contributing data on mode of delivery to the Euro-Peristat project.PopulationBirths in participating countries in 2010.MethodsCountries provided aggregated data about overall rates of obstetric intervention and about caesarean section rates for specified subgroups.Main outcome measuresMode of delivery.ResultsRates of caesarean section ranged from 14.8% to 52.2% of all births and rates of instrumental vaginal delivery ranged from 0.5% to 16.4%. Overall, there was no association between rates of instrumental vaginal delivery and rates of caesarean section, but similarities were observed between some countries that are geographically close and may share common traditions of practice. Associations were observed between caesarean section rates for women with breech and vertex births and with singleton and multiple births but patterns of association for women who had and had not had previous caesarean sections were more complex.ConclusionsThe persisting wide variations in caesarean section and instrumental vaginal delivery rates point to a lack of consensus about practice and raise questions for further investigation. Further research is needed to explore the impact of differences in clinical guidelines, healthcare systems and their financing and parents' and professionals' attitudes to care at delivery.