Kelly Sherrie, Sprague Ann, Fell Deshayne B, Murphy Phil, Aelicks Nancy, Guo Yanfang, Fahey John, Lauzon Leeanne, Scott Heather, Lee Lily, Kinniburgh Brooke, Prince Monica, Walker Mark
Better Outcomes Registry & Network (BORN) Ontario, Ottawa ON; Children's Hospital of Eastern Ontario Research Institute, Ottawa ON.
Newfoundland and Labrador Provincial Perinatal Program, St. John's NL.
J Obstet Gynaecol Can. 2013 Mar;35(3):206-214. doi: 10.1016/S1701-2163(15)30992-0.
To determine the groups within the obstetric population contributing most substantially to the Caesarean section rate in five Canadian provinces.
Hospital births from five participating provinces were grouped into Robson's 10 mutually exclusive and totally inclusive classification categories. The relative contribution of each group to the overall CS rate, relative size of group, and CS rate were calculated for British Columbia, Alberta, Ontario, Nova Scotia, and Newfoundland and Labrador for the four-year period from 2007-2008 to 2010-2011.
In all five provinces (accounting for approximately 64% of births in Canada), and for all years examined, the group making the largest relative contribution to the CS rate was women with at least one previous CS and a term, singleton, cephalic-presenting pregnancy (Robson Group 5). The CS rate for this group ranged from 76.1% in Alberta to 89.9% in Newfoundland and Labrador in 2010 to 2011, accounting for 11.3% of all deliveries. The rate of CS for Group 5 decreased slightly over the four years, except in Ontario. The next largest contributing group was nulliparous women with a term, singleton, cephalic-presenting pregnancy. Those with induced labour or Caesarean section before labour (Robson Group 2) had CS rates ranging from 34.4% in Nova Scotia to 44.6% in British Columbia (accounting for 13.1% of all deliveries), and those with spontaneous onset of labour (Robson Group 1) had CS rates of 14.5% to 20.3% in 2010 to 2011 (accounting for 23.6% of all deliveries).
All hospitals and health authorities can use this standardized classification system as part of a quality improvement initiative to monitor Caesarean section rates. This classification system identifies relevant areas for interventions and resources to reduce rates of Caesarean section.
确定加拿大五个省份产科人群中对剖宫产率贡献最大的群体。
来自五个参与省份的医院分娩病例被归入罗布森的10个相互排斥且完全涵盖的分类类别中。计算了2007 - 2008年至2010 - 2011年这四年间，不列颠哥伦比亚省、艾伯塔省、安大略省、新斯科舍省以及纽芬兰与拉布拉多省中，每个群体对总体剖宫产率的相对贡献、群体相对规模以及剖宫产率。
在所有五个省份（约占加拿大分娩总数的64%）以及所考察的所有年份中，对剖宫产率相对贡献最大的群体是有至少一次既往剖宫产史且此次为足月、单胎、头先露妊娠的女性（罗布森第5组）。该组的剖宫产率在2010至2011年间，从艾伯塔省的76.1%到纽芬兰与拉布拉多省的89.9%不等，占所有分娩的11.3%。除安大略省外，第5组的剖宫产率在这四年间略有下降。其次贡献最大的群体是足月、单胎、头先露妊娠的初产妇。那些引产或临产前剖宫产的产妇（罗布森第2组）的剖宫产率在新斯科舍省为34.4%，在不列颠哥伦比亚省为44.6%（占所有分娩的13.1%），而自然临产的产妇（罗布森第1组）在2010至2011年的剖宫产率为14.5%至20.3%（占所有分娩的23.6%）。
所有医院和卫生当局均可将此标准化分类系统用作质量改进举措的一部分，以监测剖宫产率。该分类系统确定了降低剖宫产率的干预措施和资源的相关领域。
