剖宫产与围产期死亡率的相关性

Q4 Medicine
Jasenko Fatušić, Maida Skokic, Z. Fatušić
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引用次数: 0

摘要

目的:各国剖宫产率差异很大,从0.4%-40%不等,并持续上升。我们的目的是验证剖腹产率高于15%与围产期死亡率较低无关的假设。方法:分析18年来高质量剖宫产及围产期死亡率信息资料。数据通过卡方检验进行分析,并对大值进行耶特校正。结果:剖宫产率呈上升趋势。在观察期的前六年(1998-2003年),平均剖宫产率为17,24%,第二年(2004-2010年)为19,33%,第三年(1011-2015年)为23,97%。观察期平均围产期死亡率为9.90‰,波动幅度为20.70‰~3.82‰。在观察期的前六年(1998-2003年),平均围产期死亡率为13,81‰,第二年(2004-2011年)为8,28‰,第三年(2011-2015年)为7,46‰。这些数据清楚地表明,剖宫产率的增加超过19.33%与围产期死亡率的降低无关。结论:尽管有许多建议认为,围产期死亡率的提高并不一定取决于不断增加的剖宫产率,而且世界卫生组织建议剖宫产率不应超过10-15%以优化新生儿结局,但这一建议可能太低,建议的剖宫产率为19%。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Correlation between cesarean section and perinatal mortality rate
Objectives: cesarean section rates show a wide variation among countries, ranging from 0,4-40%, and continuous rise. Our aim was to test hypothesis that higher Cesarean rate than 15% does not correlates with lower perinatal mortality rate.Methods: We analysed 18-year period with high–quality cesarean delivery and perinatal mortality rates information data. Data were analised by Chi-square test with Yate's correction for large values.Results: Cesarean section rates has increasing trend. In first six-years of observed period (1998-2003) mean cesarean section rate was 17,24%, in second (2004-2010) 19,33% and in third (1011-2015) 23,97%. In observed period mean perinatal mortality rate was 9,90‰, with fluctuation of 20,70‰ to 3,82‰. In first six-years of observed period (1998-2003) mean perinatal mortality rate was 13,81‰, in second (2004-2011) 8,28‰ and in third (2011-2015) 7,46‰. These data clearly showed that increase of cesarean section rate more than 19,33% is not correlate with decreasing od perinatal mortality.Conclusion: Despite many suggestions that improvement in perinatal mortality does not necessarily rely upon an ever-increasing cesarean section rate and recommendation by World Health Organisation that cesarean section rate should not exceed 10-15 percent to optimise neonatal outcomes, this recommendation may be too low, and suggests rate of 19%.
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来源期刊
Acta Medica Saliniana
Acta Medica Saliniana Medicine-Medicine (all)
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