帝王切開による出産率と妊産婦と新生児の死亡率の関係

George Molina¹, Thomas G Weiser², Stuart R Lipsitz³

¹Ariadne Labs at Brigham and Women's Hospital and the Harvard T.H. Chan School of Public Health, Boston, Massachusetts2Massachusetts General Hospital, Department of Surgery, Boston.

JAMA

|December 2, 2015

まとめ

全世界の帝王切開による出産率は生児100人当たり19人までで母親と新生児の死亡率との相関が逆です現在世界保健機関 (WHO) が推奨している帝王切開による出産の目標値は低すぎるかもしれない.

科学分野:

世界保健
産婦人科
公衆衛生政策

背景:

世界保健機関 (WHO) は以前,生児100人当たり10~15人の帝王切開による出産を推奨していた.
これらの推薦は,古い分析に基づいており,現代の母体および新生児のアウトカムを反映していない可能性があります.
帝王切開による出産率と死亡率の現在の関係を理解する必要があります.

研究の目的:

帝王切開による出産率と妊産婦と新生児の死亡率の現代的な関係を推定する.
帝王切開による出産率に関する現在のWHOの勧告が,現在の世界保健データと一致するかどうかを評価する.

主な方法:

2005年から2012年の間にWHO加盟国194カ国のデータを用いて,横断的な生態学的研究が行われました.
帝王切開の出産率は2012年に推定され,欠陥データのある国では計算方法が用いられました.
この研究では,国レベルでの帝王切開による出産率と,母と新生児の死亡率の相関を分析した.

主要な成果:

2012年には世界中で2200万例の帝王切開が行われたと推定されています
全国の帝王切開による出産率は,生児100人当たり約19人であったが,母子の死亡率と新生児の死亡率の両方と逆相関していた.
帝王切開による出産率の上昇は,国レベルでの母体または新生児死亡率の増加と相関していません.

結論:

約100人の生児につき19人の全国的な帝王切開による出産率は,母親と新生児の死亡率の減少と関連しています.
この結果から先ほど推奨された帝王切開の目標率は低すぎると考えられます
この研究は,現代のデータに基づいて帝王切開率に関する世界的なガイドラインを再評価する必要性を強調しています.

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