Barros F C, Vaughan J P, Victora C G, Huttly S R
Department of Social Medicine, Universidade Federal de Pelotas, Brazil.
Lancet. 1991 Jul 20;338(8760):167-9. doi: 10.1016/0140-6736(91)90149-j.
Brazil has one of the highest rates of caesarean section in the world. Patterns of caesarean sections were studied in a cohort of 5960 mothers followed from 1982 to 1986 in southern Brazil. Overall, 27.9% were delivered by caesarean section in 1982, this proportion being 30% for nulliparae, 80% for second deliveries when the first was by caesarean, and over 99% for third births when the first two were by caesarean. Socioeconomic status and requests for sterilisation by tubal ligation were important underlying factors. 9.4% of the women were sterilised during a caesarean section (3.7% in the lowest income group and 20.2% in the highest). 31% of women who had had their first child by a caesarean section and who were having a second operative delivery were sterilised. The high rates of caesarean sections and accompanying sterilisations reflect the lack of appropriate reproductive and contraceptive policies in the country.
巴西是世界上剖宫产率最高的国家之一。1982年至1986年期间，对巴西南部5960名母亲组成的队列进行了剖宫产模式研究。总体而言，1982年剖宫产分娩率为27.9%，初产妇为30%，第一胎为剖宫产的经产妇第二胎剖宫产率为80%，前两胎均为剖宫产的经产妇第三胎剖宫产率超过99%。社会经济地位和输卵管结扎绝育要求是重要的潜在因素。9.4%的女性在剖宫产时接受了绝育手术（低收入组为3.7%，高收入组为20.2%）。第一胎为剖宫产且进行第二次手术分娩的女性中有31%接受了绝育手术。高剖宫产率及随之而来的绝育率反映出该国缺乏适当的生殖和避孕政策。
