医生对剖腹产风险的评估 性别
Yuki Joyama1, Misa Hayasaka2, Lindsay Speros Robbins2
1Biostatistics, Columbia University Mailman School of Public Health, New York, United States.
American journal of perinatology
|May 19, 2025
概括
与男性医生相比,女性医生进行的剖腹产次数较少,特别是在没有进展的情况下,而不会增加新生儿并发症. 这一发现突出了基于医生性别的产科实践中的潜在差异.
科学领域:
- 产科和妇科 产科和妇科
- 围产儿医学 围产儿医学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 医生性别越来越被认为是一个可能影响临床决策和患者结果的因素.
- 以前的研究已经探讨了基于医生人口统计学的医疗实践变化,但剖腹产分娩率的性别差异数据仍然有限.
研究的目的:
- 调查分娩医生的性别与剖腹产和新生儿并发症的发生率之间的关联.
- 分析与医生性别有关的剖腹产的具体指示.
主要方法:
- 对2002年至2008年间228,437次分娩的大型数据库 (安全劳动联盟) 的分析.
- 包括单体,头部表现,不包括特殊情况,如选择性剖腹产或非医生管理.
- 使用概括估计方程来估计医生性别对剖腹产产率的平均边际影响,并对相关共变量进行调整.
主要成果:
- 与男性医生相比,女性医生的剖腹产总体比例较低 (11.93%对13.47%).
- 这种降低在剖腹产中是显著的,原因是未能进展 (5.72%对6.48%) 和其他迹象,不包括未能进展或不令人放心的胎儿心脏追踪.
- 对于不令人放心的胎儿心脏跟踪或复合新生儿并发症的剖腹产结果,没有观察到显著差异.
结论:
- 与男性医生相比,女性医生的剖腹产率较低.
- 观察到女性医生的剖腹产减少与新生儿不良后果风险增加无关.
- 需要进一步的研究来阐明这些差异背后的机制,并为临床实践指南提供信息.
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