Divisão População e Saúde, Faculdade de Medicina, Universidade Federal do Rio Grande, Rio Grande, RS, Brasil.
Rev Saude Publica. 2010 Feb;44(1):80-9. doi: 10.1590/s0034-89102010000100009.
To analyze the rate of cesarean section and differences in risk factors by category of health service, either public or private.
A cross-sectional study was carried out including all pregnant women in labor admitted to hospitals in the city of Rio Grande, Southern Brazil, between January 1 and December 31, 2007. A pre-coded and pre-tested questionnaire was used to collect on social, demographic, obstetric and newborn care information. Two regression models were constructed: one for public users and the other one for private ones. Poisson regression was used in each model in the multivariate analysis. Prevalence rates and 95% confidence intervals were calculated for each adjusted factor.
The rate of cesarean section was 43% and 86% among public and private users. Sociodemographic factors and twin births have a more significant impact among public users as well as number of pregnancies (25% vs. 13% reduction in public and private users, respectively) and previous cesarean section (86% vs. 24% increase in public and private users, respectively). Prenatal care visits and hospital admissions affected the outcome only in women users of public services.
Cesarean section rates were high in both groups studied, but it was twice as high among women cared in the private sector. Associated factors differ in magnitude by category of service used.
分析按公共或私人卫生服务类别分类的剖宫产率和差异的危险因素。
这是一项横断面研究，纳入了 2007 年 1 月 1 日至 12 月 31 日期间在巴西南部里奥格兰德州城市的医院分娩的所有孕妇。使用预先编码和预先测试的问卷收集社会人口统计学、产科和新生儿护理信息。为公共用户和私人用户分别构建了两个回归模型。多元分析中每个模型均使用泊松回归。计算了每个调整因素的流行率和 95%置信区间。
公共用户和私人用户的剖宫产率分别为 43%和 86%。社会人口统计学因素和双胞胎分娩对公共用户的影响更大，以及妊娠次数（公共和私人用户分别减少 25%和 13%）和既往剖宫产（公共和私人用户分别增加 86%和 24%）。产前护理就诊和住院仅影响公共服务使用者的女性的结局。
两组的剖宫产率均较高，但在私人部门接受护理的女性中，剖宫产率是公共部门的两倍。相关因素的大小因使用的服务类别而异。
