Almeida Sueli de, Bettiol Heloisa, Barbieri Marco Antonio, Silva Antônio Augusto Moura da, Ribeiro Valdinar Sousa
Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, Brasil.
Cad Saude Publica. 2008 Dec;24(12):2909-18. doi: 10.1590/s0102-311x2008001200020.
This paper evaluates the association of maternal variables and of variables related to prenatal and delivery care with cesarean sections at a public and at a private maternity. A retrospective cross-sectional study was performed at a public maternity clinic (2,889 deliveries) and at a private maternity clinic (2,911 deliveries) in the city of Ribeirão Preto, São Paulo State, Brazil. The prevalence of cesarean sections was 18.9% at the public maternity clinic and 84.3% at the private one. The factors associated with cesarean sections at both hospitals were: mothers from other cities, aged > or =25 years and with hypertension. Having more than one child was a protective factor. At the public hospital, cesarean sections were more frequent on Wednesdays and from 12:00 to 23:59 hours of any day of the week, whereas at the private hospital they occurred on any day, though were less common on Sundays, and at any time except in the early morning. At the private hospital, cesarean sections were more frequent when performed by the doctor who had provided the prenatal care. Non-medical factors were more associated with cesarean sections in the private maternity clinic than biological or clinical factors related to pregnancy.
本文评估了在一家公立医院和一家私立产科医院中，产妇变量以及与产前和分娩护理相关的变量与剖宫产之间的关联。在巴西圣保罗州里贝朗普雷图市的一家公立产科诊所（2889例分娩）和一家私立产科诊所（2911例分娩）开展了一项回顾性横断面研究。公立产科诊所的剖宫产患病率为18.9%，私立产科诊所为84.3%。两家医院与剖宫产相关的因素有：来自其他城市的产妇、年龄≥25岁且患有高血压。子女数量超过一个是一个保护因素。在公立医院，周三以及一周中任何一天的12:00至23:59进行剖宫产更为频繁，而在私立医院，剖宫产在任何一天都有发生，不过在周日较少见，且除清晨外的任何时间都有。在私立医院，由提供产前护理的医生进行剖宫产时更为频繁。与妊娠相关的生物学或临床因素相比，私立产科诊所的剖宫产更多与非医学因素相关。
