Department of Community Health Sciences, Boston University School of Public Health, Boston, MA 02118, USA.
Birth. 2011 Jun;38(2):99-104. doi: 10.1111/j.1523-536X.2010.00459.x. Epub 2011 Mar 10.
Cesarean delivery rates have been rising rapidly in many countries in the last decade. The objective of this research is to examine cesarean rates in industrialized countries and assess patterns in the trends toward increasing rates.
We examined cesarean delivery rates per 1,000 live births from 1987 to 2007 in 22 industrialized countries. To enhance comparability, the inclusion criteria were at least 50,000 births annually and a per capita gross domestic product of at least U.S.$10,000 in 2007. Poisson regression was selected to model the cesarean delivery rates of countries across time.
We examined overall cesarean delivery rates, absolute changes in these rates, and changes in trend lines for cesarean rates for the period from 1987 to 2007. In 2007, 11 of the 21 countries reported overall cesarean rates of more than 25 percent, led by Italy (39%), Portugal (35%), the United States (32%), and Switzerland (32%). Five countries, the Slovak Republic, Czech Republic, Ireland, Austria, and Hungary more than doubled their cesarean delivery rate between 1992 and 2007. Comparing changes in rates across time periods, 14 countries experienced a greater increase in rates in the period between 1998 and 2002 compared with the period between 1993 and 1997. Comparing trends from 2003-2007 to 1998-2002, eighteen countries experienced a slowing down of rate increases across these two periods.
Although cesarean delivery rates continue to rise, the rate of increase appears to be slowing down in most industrialized countries.
在过去十年中，许多国家的剖宫产率迅速上升。本研究的目的是检查工业化国家的剖宫产率，并评估剖宫产率上升趋势的模式。
我们检查了 1987 年至 2007 年 22 个工业化国家每 1000 例活产的剖宫产率。为了增强可比性，纳入标准是每年至少有 50000 例分娩，以及 2007 年人均国内生产总值至少为 10000 美元。选择泊松回归来模拟国家随时间的剖宫产率。
我们检查了总体剖宫产率、这些率的绝对变化以及 1987 年至 2007 年剖宫产率趋势线的变化。2007 年，21 个国家中有 11 个报告的总体剖宫产率超过 25%，其中意大利（39%）、葡萄牙（35%）、美国（32%）和瑞士（32%）位居前列。五个国家，即斯洛伐克共和国、捷克共和国、爱尔兰、奥地利和匈牙利，在 1992 年至 2007 年间，其剖宫产率翻了一番以上。比较不同时间段的费率变化，14 个国家在 1998 年至 2002 年期间的费率增长率高于 1993 年至 1997 年期间。比较 2003-2007 年和 1998-2002 年的趋势，18 个国家在这两个时期的增长率都有所放缓。
尽管剖宫产率仍在继续上升，但在大多数工业化国家，上升速度似乎正在放缓。
