欧洲公立医院与私立医院的剖腹产率:使用罗布森十组分类系统进行系统审查和元分析
Sara Ebadi1, Viktoria El Radaf2, Tahir Mahmood3
1Obstetrics and Gynaecology, Institution of Clinical Sciences Lund, Lund University, Sweden.
概括
剖腹产率在整个欧洲都很高,特别是在南欧和私人医院. 低风险妇女的不必要手术对这些高率有很大影响,尤其是在私人机构.
科学领域:
- 产科和妇科 产科和妇科
- 公共卫生 公共卫生
- 医疗保健服务研究 医疗服务研究
背景情况:
- 剖腹产的全球增长需要了解区域差异.
- CS可以挽救生命,但非必要的程序对母亲和新生儿有风险.
- 公立和私立医院之间的CS率差异需要调查.
研究的目的:
- 分析欧洲公立和私立医院之间CS率的变化.
- 使用罗布森十组分类来比较国家和区域级别的CS率.
- 确定导致欧洲CS费率差异的因素.
主要方法:
- 来自25个欧洲国家的研究 (2000-2025) 的系统审查.
- 包括报告出生情况的研究,罗布森组,英语或瑞典语.
- 绝对数和百分比的元分析;偏差风险评估.
主要成果:
- 46项研究分析了12,505,939个出生;南欧的CS率最高 (54.9%).
- 在南欧,私立医院的CS率 (73.1%) 比公立医院 (40.9%) 高得多.
- 低风险女性 (罗布森组1-4) 在私立医院和公立医院的CS率明显更高.
结论:
- 高CS率在欧洲普遍存在,南欧和私人医院显示最高水平.
- 私立医院的过度CS是由低风险妇女不必要的手术驱动的.
- 需要紧急干预,以促进基于证据的护理,并减少非必要的CS,特别是在低风险人群中.
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