产科活动增加：“引产”的新含义？
Increased obstetric activity: a new meaning to "induced labour"?
作者信息
Vallgårda S
机构信息
Institute of Social Medicine, University of Copenhagen, Denmark.
出版信息
J Epidemiol Community Health. 1989 Mar;43(1):48-52. doi: 10.1136/jech.43.1.48.
This study examines the possible reasons for increased obstetric activity in Denmark over the past 25 years. Since 1960 there has been a substantial increase in the average number of hospital admissions (from 10 to 32 per 100 deliveries), in deliveries diagnosed as complicated (from 15 to 49%), and above all in major interventions at delivery (from 4 to 22%). In spite of this increase in activity there is no evidence that the postwar trend of decreasing perinatal mortality has been further improved during the period of study. It seems possible that the rising level of activity is the result of increasing availability of new technology, decreasing numbers of deliveries and unchanged obstetric staffing levels, with an increased tendency to diagnose and intervene in "at risk" pregnancies. There is a need to determine how the current level of obstetric activity has arisen. Since there is evidence for an increased expectation of intervention by pregnant women, the theory of supplier induced demand may be among the leading contenders to be tested.
本研究探讨了丹麦过去25年产科活动增加的可能原因。自1960年以来，平均住院人数大幅增加（从每100例分娩中的10例增至32例），诊断为复杂分娩的比例增加（从15%增至49%），最重要的是分娩时的重大干预措施增加（从4%增至22%）。尽管活动有所增加，但没有证据表明在研究期间，战后围产期死亡率下降的趋势得到了进一步改善。活动水平上升似乎是由于新技术的可及性增加、分娩数量减少以及产科人员配置水平不变，同时对“高危”妊娠进行诊断和干预的趋势增强。有必要确定当前产科活动水平是如何形成的。由于有证据表明孕妇对干预的期望增加，供给诱导需求理论可能是有待检验的主要竞争者之一。
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