Maternal risk profiles and the primary cesarean rate in the United States, 1991-2002
Maternal risk profiles and the primary cesarean rate in the United States, 1991-2002
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DOI：
10.2105/ajph.2004.052381
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发表时间：
2006-05-01
影响因子：
12.7
通讯作者：
MacDorman, M
中科院分区：
文献类型：
--
作者：
Declercq, E;Menacker, F;MacDorman, M
目标。我们研究了 1991 年至 2002 年间导致美国初次剖宫产率变化的因素。方法。美国国家出生证明数据用于评估根据产妇年龄、胎次和种族/民族分层的初次剖宫产率的变化。研究了出生证明上列出的医疗风险因素或临产或分娩并发症的发生趋势，以及此类情况的相应初次剖宫产率。结果。最近总体剖宫产率上升的一半以上（53%）是由于初次剖宫产率上升所致。从1991年到1996年，初次剖腹产率稳步下降，随后从1996年到2002年迅速上升。2002年，超过四分之一的初产妇通过剖腹产分娩。初次剖宫产率的变化与母亲医疗风险状况的总体变化无关。然而，出生证明上列出的几乎所有疾病的发病率都以与总体发病率相同的模式变化。结论。我们的结果表明，研究期间初次剖宫产率的变化与孕产妇风险状况的变化无关。
Objectives. We examined factors contributing to shifts in primary cesarean rates in the United States between 1991 and 2002.Methods. US national birth certificate data were used to assess changes in primary cesarean rates stratified according to maternal age, parity, and race/ethnicity. Trends in the occurrence of medical risk factors or complications of labor or delivery listed on birth certificates and the corresponding primary cesarean rates for such conditions were examined.Results. More than half (53%) of the recent increase in overall cesarean rates resulted from rising primary cesarean rates. There was a steady decrease in the primary cesarean rate from 1991 to 1996, followed by a rapid increase from 1996 to 2002. In 2002, more than one fourth of first-time mothers delivered their infants via cesarean. Changing primary cesarean rates were not related to general shifts in mothers' medical risk profiles. However, rates for virtually every condition listed on birth certificates shifted in the same pattern as with the overall rates.Conclusions. Our results showed that shifts in primary cesarean rates during the study period were not related to shifts in maternal risk profiles.