Shabila Nazar P
Department of Community Medicine, College of Medicine, Hawler Medical University, Erbil, Iraq.
BMC Pregnancy Childbirth. 2017 Jan 11;17(1):22. doi: 10.1186/s12884-016-1211-6.
The prevalence of cesarean sections is increasing globally; however, it can lead to significant increases in maternal and infant morbidity and mortality. This study aimed to determine the rates and trends of cesarean sections in Iraq.
The cesarean section rates of all births and public and private hospital-based births were calculated from the data on births provided by the annual reports of the Iraqi Ministry of Health for the years 2008 and 2012. The comparable rates for the Center/South and Kurdistan Region and the individual governorates were determined. The cesarean section rates for all births in 2008 were computed and compared with the 2012 rates.
The cesarean section rate for all births in Iraq was 24.4% in 2012, which was similar to the rates in the Iraqi Kurdistan Region (25.4%) and the Center/South of Iraq (24.3%). The cesarean section rates were specifically high in the governorates containing a larger number of private hospitals, and there was a significant positive relationship between the number of private hospitals and the cesarean section rate (beta = 0.671; r = 0.671; P < 0.002). The hospital-based cesarean section rate was 34.7%. The cesarean section rate in private hospitals (77.9%) was remarkably higher than the rate in public hospitals (29.3%). The overall rate of cesarean sections in Iraq increased from 18.0% in 2008 to 24.4% in 2012.
The cesarean section rate in Iraq is far above the recommended rate. Iraq witnessed a rapid upward trend in the cesarean section rate from 2008 to 2012, with most of this trend attributable to the Kurdistan Region. There is a potential relationship between the expansion of the private health sector and the increasing cesarean section rate, and further studies of this relationship are necessary. Future research should consider an audit of the indications for a cesarean section rather than measuring the cesarean section rate alone.
剖宫产的全球患病率正在上升；然而，这可能导致母婴发病率和死亡率显著增加。本研究旨在确定伊拉克剖宫产的发生率及趋势。
根据伊拉克卫生部2008年和2012年年度报告提供的出生数据，计算所有分娩以及公立和私立医院分娩的剖宫产率。确定了中部/南部和库尔德地区以及各省份的可比率。计算了2008年所有分娩的剖宫产率，并与2012年的剖宫产率进行比较。
2012年伊拉克所有分娩的剖宫产率为24.4%，与伊拉克库尔德地区（25.4%）和伊拉克中部/南部（24.3%）的剖宫产率相似。在私立医院数量较多的省份，剖宫产率特别高，私立医院数量与剖宫产率之间存在显著的正相关关系（β = 0.671；r = 0.671；P < 0.002）。医院剖宫产率为34.7%。私立医院的剖宫产率（77.9%）显著高于公立医院（29.3%）。伊拉克剖宫产的总体发生率从2008年的18.0%上升到2012年的24.4%。
伊拉克的剖宫产率远高于推荐率。2008年至2012年期间，伊拉克剖宫产率呈快速上升趋势，这一趋势主要归因于库尔德地区。私立卫生部门的扩张与剖宫产率上升之间可能存在关联，有必要对这种关联进行进一步研究。未来的研究应考虑对剖宫产指征进行审核，而不仅仅是测量剖宫产率。
