Penfield Christina A, Lahiff Maureen, Pies Cheri, Caughey Aaron B
Department of Obstetrics and Gynecology, Irvine Medical Center, University of California, Berkeley, California.
University of California, Berkeley, School of Public Health, Berkeley, California.
Am J Perinatol. 2017 Jan;34(2):123-129. doi: 10.1055/s-0036-1584580. Epub 2016 Jun 20.
To determine how an adolescent's risk of cesarean varies by maternal age and race/ethnicity, and evaluate the contribution of obstetric and sociodemographic factors to mode of delivery. This is a retrospective cohort study of 604,287 births to women aged 13 to 23 years. Regression techniques were used to determine maternal ages at lowest risk of primary cesarean in each major racial/ethnic group before and after adjustment for various cesarean risk factors. Adolescent age was associated with lower risk of cesarean compared with young adults (17.2% at age 13 years vs 24.8% at age 23 years, < 0.05). After stratification by race/ethnicity, Non-Hispanic Black women had the highest probability of cesarean, while Asian/Pacific Islanders had the lowest probability across all ages. When compared with young adults of the same race/ethnicity, young adolescents continued to have a lower risk of cesarean, decreased by at least 30% until age 18 years (White) and 17 years (other racial/ethnic groups). These associations persisted after adjustment for obstetric and sociodemographic risk factors. Young maternal age is protective against cesarean delivery in all racial/ethnic groups. Adolescents also experience racial/ethnic disparities in mode of delivery similar to those observed in adults, which were unexplained by either obstetric or sociodemographic factors.
为确定青少年剖宫产风险如何随母亲年龄及种族/族裔而变化，并评估产科和社会人口学因素对分娩方式的影响。这是一项对604287例年龄在13至23岁女性分娩情况的回顾性队列研究。运用回归技术确定在调整各种剖宫产风险因素前后，各主要种族/族裔组中初次剖宫产风险最低时的母亲年龄。与年轻成年人相比，青少年剖宫产风险较低（13岁时为17.2%，23岁时为24.8%，P<0.05）。按种族/族裔分层后，非西班牙裔黑人女性剖宫产概率最高，而亚太岛民在所有年龄段剖宫产概率最低。与同种族/族裔的年轻成年人相比，青少年剖宫产风险持续较低，在18岁（白人）和17岁（其他种族/族裔组）之前至少降低30%。在调整产科和社会人口学风险因素后，这些关联依然存在。年轻母亲年龄对所有种族/族裔组的剖宫产分娩具有保护作用。青少年在分娩方式上也存在与成年人相似的种族/族裔差异，而这两种差异均无法用产科或社会人口学因素来解释。
