Zhu Yi-bo, Li Hong-tian, Zhang Ya-li, Li Zhi-wen, Zhang Le, Liu Jian-meng
Department of Epidemiology & Biostatistics, School of Public Health, Peking University Health Science Center, Beijing 100191, China.
Zhonghua Yi Xue Za Zhi. 2012 Jul 3;92(25):1734-7.
To explore the secular trends of cesarean delivery and cesarean delivery on maternal request (CDMR) among primiparous women with singleton pregnancy in Southern and Northern China.
The Perinatal Healthcare Surveillance System was established in 26 counties/cities of 3 Chinese provinces since 1993. A total of 1 317 774 primiparous women with singleton pregnancy were monitored through the system during the 1993 - 2010 period. Chi-square tests were performed to assess the linear trends in the prevalence of cesarean delivery and CDMR.
During the 18-year period, 496 054 cesarean deliveries and 129 219 CDMRs were identified. The prevalence rates of cesarean delivery and CDMR were 37.6% and 10.0% respectively. CDMR accounted for 26.0% of all cesarean births. The prevalence of cesarean delivery increased from 29.4% during the 1993 - 1995 period to 58.7% during the 2006 - 2010 in Southern urban area, from 18.2% to 58.3% in Southern rural area and from 4.3% to 49.5% in Northern rural area. The prevalence of CDMR increased by 34 folds from 0.6% during the 1993 - 1995 period to 21.3% during the 2006 - 2010 period in Southern urban area, by 40 folds from 0.6% to 24.4% in Southern rural area and by 44 folds from 0.6% to 27.3% in Northern rural area. The proportions of CDMR in all cesarean deliveries significantly increased in all three regions. Women aged over 30 years, overweight and well-educated were more likely to experience a cesarean delivery including CDMR.
The Chinese prevalence rates of cesarean delivery and CDMR increased dramatically during the 1993 - 2010 period and ranked the highest in the world by 2010. And CDMR became a non-negligible component in all cesarean sections.
探讨中国南方和北方单胎初产妇剖宫产及产妇要求剖宫产（CDMR）的长期趋势。
自1993年起在中国3个省份的26个县/市建立围产期保健监测系统。1993 - 2010年期间，通过该系统共监测了1317774名单胎初产妇。采用卡方检验评估剖宫产和CDMR患病率的线性趋势。
在这18年期间，共识别出496054例剖宫产和129219例CDMR。剖宫产和CDMR的患病率分别为37.6%和10.0%。CDMR占所有剖宫产分娩的26.0%。南方城市地区剖宫产患病率从1993 - 1995年期间的29.4%增至2006 - 2010年期间的58.7%，南方农村地区从18.2%增至58.3%，北方农村地区从4.3%增至49.5%。南方城市地区CDMR患病率从1993 - 1995年期间的0.6%增至2006 - 2010年期间的21.3%，增长了34倍，南方农村地区从0.6%增至24.4%，增长了40倍，北方农村地区从0.6%增至27.3%，增长了44倍。所有三个地区CDMR在所有剖宫产分娩中的比例均显著增加。30岁以上、超重和受过良好教育的女性更有可能接受包括CDMR在内的剖宫产。
1993 - 2010年期间，中国剖宫产和CDMR患病率急剧上升，到2010年位居世界最高。并且CDMR在所有剖宫产中成为一个不可忽视的组成部分。
