The Increasing Trend in Caesarean Section Rates: Global, Regional and National Estimates: 1990-2014.
The Increasing Trend in Caesarean Section Rates: Global, Regional and National Estimates: 1990-2014.
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DOI：
10.1371/journal.pone.0148343
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发表时间：
2016
期刊：
影响因子：
3.7
通讯作者：
Torloni MR
中科院分区：
文献类型：
--
作者：
Betrán AP;Ye J;Moller AB;Zhang J;Gülmezoglu AM;Torloni MR
剖腹产（CS）率继续引起全世界的关注，因为他们的稳步增长，缺乏共识的适当CS率和相关的额外的短期和长期的风险和成本。我们提供了过去24年的最新CS率和趋势。我们收集了1990年至2014年间具有全国代表性的CS率数据，并计算了区域和次区域加权平均值。我们进行了纵向分析，计算CS率的绝对变化和平均年增长率（AARI）的差异。根据来自150个国家的最新数据，目前所有分娩中有18.6%是通过剖宫产进行的，在最不发达和最发达地区分别为6%至27.2%。拉丁美洲和加勒比地区的CS率最高（40.5%），其次是北方美洲（32.3%）、大洋洲（31.1%）、欧洲（25%）、亚洲（19.2%）和非洲（7.3%）。基于121个国家的数据，趋势分析显示，1990年至2014年，全球平均CS率上升了12.4%（从6.7%上升到19.1%），年均增长率为4.4%。拉丁美洲和加勒比的绝对增长幅度最大（19.4%，从22.8%降至42.2%），其次是亚洲（15.1%，从4.4%降至19.5%），大洋洲（14.1%，从18.5%到32.6%）、欧洲（13.8%，从11.2%到25%）、北方美洲（10%，从22.3%到32.3%）和非洲（4.5%，从2.9%到7.4%）。亚洲和北方美洲是平均年增长率最高和最低的区域（分别为6.4%和1.6%）。全世界对计算机辅助的使用已增加到前所未有的水平，尽管资源较高和较低的环境之间的差距仍然存在。所提供的信息对于为旨在优化利用计算机服务的政策以及全球和区域战略提供信息至关重要。
Caesarean section (CS) rates continue to evoke worldwide concern because of their steady increase, lack of consensus on the appropriate CS rate and the associated additional short- and long-term risks and costs. We present the latest CS rates and trends over the last 24 years. We collected nationally-representative data on CS rates between 1990 to 2014 and calculated regional and subregional weighted averages. We conducted a longitudinal analysis calculating differences in CS rates as absolute change and as the average annual rate of increase (AARI). According to the latest data from 150 countries, currently 18.6% of all births occur by CS, ranging from 6% to 27.2% in the least and most developed regions, respectively. Latin America and the Caribbean region has the highest CS rates (40.5%), followed by Northern America (32.3%), Oceania (31.1%), Europe (25%), Asia (19.2%) and Africa (7.3%). Based on the data from 121 countries, the trend analysis showed that between 1990 and 2014, the global average CS rate increased 12.4% (from 6.7% to 19.1%) with an average annual rate of increase of 4.4%. The largest absolute increases occurred in Latin America and the Caribbean (19.4%, from 22.8% to 42.2%), followed by Asia (15.1%, from 4.4% to 19.5%), Oceania (14.1%, from 18.5% to 32.6%), Europe (13.8%, from 11.2% to 25%), Northern America (10%, from 22.3% to 32.3%) and Africa (4.5%, from 2.9% to 7.4%). Asia and Northern America were the regions with the highest and lowest average annual rate of increase (6.4% and 1.6%, respectively). The use of CS worldwide has increased to unprecedented levels although the gap between higher- and lower-resource settings remains. The information presented is essential to inform policy and global and regional strategies aimed at optimizing the use of CS.