WHO global survey on maternal and perinatal health in Latin America: classifying caesarean sections.
WHO global survey on maternal and perinatal health in Latin America: classifying caesarean sections.
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DOI：
10.1186/1742-4755-6-18
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发表时间：
2009-10-29
影响因子：
3.4
通讯作者：
Bataglia V
中科院分区：
文献类型：
--
作者：
Betrán AP;Gulmezoglu AM;Robson M;Merialdi M;Souza JP;Wojdyla D;Widmer M;Carroli G;Torloni MR;Langer A;Narváez A;Velasco A;Faúndes A;Acosta A;Valladares E;Romero M;Zavaleta N;Reynoso S;Bataglia V
全球剖腹产率持续上升，医疗后果不确定。以可靠、持续的方式审核和分析剖腹产率和其他围产期结局对于了解剖腹产随时间变化的原因至关重要。我们分析了 8 个国家 120 个设施中 97,095 名妇女的分娩数据，这些数据是 2004-2005 年拉丁美洲孕产妇和围产期健康全球调查的一部分。这项分析的目的是测试“10组”或“罗布森”分类是否可以帮助确定哪些妇女群体对拉丁美洲的高剖腹产率影响最大，以及是否可以为医疗保健提供者提供有用的信息，以监测和规划有效行动以降低这些比率。总体剖腹产率为35.4%。未曾进行过剖腹产且自然分娩的足月单头妊娠妇女（第 1 组和第 3 组）占产科总人数的 60%。尽管曾进行过剖腹产的足月单胎头颅妊娠妇女（第 5 组）仅占产科人群的 11.4%，但该组是剖腹产总体率的最大贡献者（占所有剖腹产的 26.7%）。剖宫产率的第二和第三大贡献者是足月单头妊娠的未产妇，无论是自然分娩（第 1 组）还是在临产前通过剖腹产引产或分娩（第 2 组），分别占所有剖腹产的 18.3% 和 15.3%。 10 组分类可以轻松应用于多国数据集，而不会出现不一致或错误分类的问题。特定妇女群体被明确确定为总体剖腹产率的主要贡献者。这种分类可以帮助卫生保健提供者针对特定妇女群体制定切实有效的行动，以改善孕产妇和围产期护理。
Caesarean section rates continue to increase worldwide with uncertain medical consequences. Auditing and analysing caesarean section rates and other perinatal outcomes in a reliable and continuous manner is critical for understanding reasons caesarean section changes over time. We analyzed data on 97,095 women delivering in 120 facilities in 8 countries, collected as part of the 2004-2005 Global Survey on Maternal and Perinatal Health in Latin America. The objective of this analysis was to test if the "10-group" or "Robson" classification could help identify which groups of women are contributing most to the high caesarean section rates in Latin America, and if it could provide information useful for health care providers in monitoring and planning effective actions to reduce these rates. The overall rate of caesarean section was 35.4%. Women with single cephalic pregnancy at term without previous caesarean section who entered into labour spontaneously (groups 1 and 3) represented 60% of the total obstetric population. Although women with a term singleton cephalic pregnancy with a previous caesarean section (group 5) represented only 11.4% of the obstetric population, this group was the largest contributor to the overall caesarean section rate (26.7% of all the caesarean sections). The second and third largest contributors to the overall caesarean section rate were nulliparous women with single cephalic pregnancy at term either in spontaneous labour (group 1) or induced or delivered by caesarean section before labour (group 2), which were responsible for 18.3% and 15.3% of all caesarean deliveries, respectively. The 10-group classification could be easily applied to a multicountry dataset without problems of inconsistencies or misclassification. Specific groups of women were clearly identified as the main contributors to the overall caesarean section rate. This classification could help health care providers to plan practical and effective actions targeting specific groups of women to improve maternal and perinatal care.