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剖腹产率与产妇和新生儿死亡率之间的关系
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
概括
全球剖腹产率高达每100个活产中的19个, 与孕产妇和新生儿死亡率呈反向相关性. 目前世界卫生组织 (WHO) 建议的国家剖腹产目标可能过低.
科学领域:
- 全球健康
- 产科和妇科
- 公共卫生政策
背景情况:
- 世界卫生组织 (WHO) 曾建议全国的剖腹产率在每100名活产儿中为10-15.
- 这些建议是基于较旧的分析,可能不反映当代母亲和新生儿的结果.
- 优化母亲和新生儿的结果需要了解剖腹产率与死亡率之间的关系.
研究的目的:
- 估计国家剖腹产率与产妇和新生儿死亡率之间的当代关系.
- 评估当前世卫组织关于剖腹产率的建议是否与当前的全球健康数据一致.
主要方法:
- 在2005年至2012年间对194个世卫组织成员国的数据进行了横截面的生态研究.
- 估计了2012年的剖腹产率,并使用了缺少数据的国家的归算方法.
- 该研究分析了各国剖腹产率与产妇和新生儿死亡率之间的相关性.
主要成果:
- 在2012年,全球估计有2290万例剖腹产.
- 全国剖腹产率高达大约每100个活产儿中的19个与产妇和新生儿死亡率呈反向相关性.
- 在国家一级,较高的剖腹产率与增加的孕产妇或新生儿死亡率无关.
结论:
- 全国剖腹产率高达大约每100个活产中的19个,与降低的孕产妇和新生儿死亡率有关.
- 这些发现表明先前推的剖腹产国家目标率可能过低.
- 这项研究强调需要根据当代数据重新评估剖腹产率的全球指导方针.
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