Denk Charles E, Kruse Lakota K, Jain Neetu J
Maternal and Child Health Epidemiology Program, New Jersey Department of Health and Senior Services, Trenton, New Jersey08625-0364, USA.
Birth. 2006 Sep;33(3):203-9. doi: 10.1111/j.1523-536X.2006.00105.x.
Nationally and in New Jersey, the cesarean delivery rate has been increasing steadily for nearly a decade, and especially since 1999. The purpose of this study was to describe recent trends in cesarean section delivery in New Jersey.
Data on delivery method, medical indications and patient characteristics were extracted from electronic birth certificate files.
Cesarean section deliveries increased as a proportion of live births by 6 percent annually. Growth was roughly uniform across Robson's clinical classification. Repeat cesareans contributed only proportionately to the overall trend. The greatest acceleration was observed for procedures without trial of labor, and in medical situations where cesarean delivery had been relatively rare.
Medical indications recorded on the birth certificate explained little of the rapid growth in utilization of cesarean delivery, since trends were comparable in most categories we examined. A sustained autonomous shift in practice patterns, patient preferences, or both seems the most likely driver of the overall trend.
在全国范围内以及新泽西州，剖宫产率在近十年中一直在稳步上升，尤其是自1999年以来。本研究的目的是描述新泽西州剖宫产分娩的近期趋势。
从电子出生证明文件中提取分娩方式、医学指征和患者特征的数据。
剖宫产分娩占活产的比例每年增加6%。在罗布森临床分类中，增长大致均匀。再次剖宫产仅按比例促成了总体趋势。在未经试产的手术以及剖宫产相对较少的医疗情况下，观察到增长最为迅速。
出生证明上记录的医学指征对剖宫产使用率的快速增长解释甚少，因为在我们研究的大多数类别中趋势相似。实践模式、患者偏好或两者的持续自主转变似乎是总体趋势最可能的驱动因素。
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