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什么是最安全的人口级剖腹产分娩率? 一项使用自然变异的全国性队列研究
Dag Moster1,2, Allen J Wilcox3,4, Rolv Terje Lie1,4
1Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.
概括
挪威的剖腹产率为10%,与20%的比率相比,与新生儿脑病和脑的风险更高有关. 这项研究强调了剖腹产分娩率对母亲和婴儿健康结果的影响.
科学领域:
- 产科和妇科 产科和妇科
- 公共卫生 公共卫生
- 新生儿医学 新生儿医学
背景情况:
- 剖腹产 (CS) 的最佳率长期以来一直受到争议,通常在没有强有力的证据的情况下建议10-15%.
- 挪威的医疗保健系统提供了一个独特的环境来研究CS率的变化及其对健康结果的影响,这是由于普遍获得高质量的护理.
研究的目的:
- 调查当地剖腹产率与挪威各种孕产妇和婴儿健康结果之间的关联.
- 提供数据,为正在进行的关于最佳剖腹产率的讨论提供信息.
主要方法:
- 使用1995-2014年挪威出生数据进行了前性国家队列研究.
- 分析了435个市镇的每年剖腹产率和健康结果,以母亲的住所作为分析单位,以减轻转诊偏差.
- 根据分析前两年和每年之后的数据计算率,以尽量减少指示偏差,并根据年度和灵敏度分析进行调整.
主要成果:
- 在8647个市政年份组合中,分析了超过117万次交付.
- 剖腹产的发产率在各市区的10%到20%之间,平均为16%.
- 不良结果,包括周围眼,新生儿脑病,脑和死胎,在较低的CS率 (约10%),更频繁,而严重的母亲出血较少.
结论:
- 在挪威,剖腹产产率为10%与新生儿脑病和脑的风险显著增加,而这一比例为20%.
- 这些发现表明,在观察到的范围内,较高的剖腹产率可能与在资源充足的医疗保健系统中改善婴儿神经结果有关.
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