Abebe Eyowas Fantu, Negasi Ashebir Kidane, Aynalem Gizachew Eyassu, Worku Abebaw Gebeyehu
International NGO, Strengthening Human Resource for Health, Bahir Dar.
Institute of Public Health, University of Gondar, Gondar, Ethiopia.
Pediatric Health Med Ther. 2016 Jul 1;7:65-70. doi: 10.2147/PHMT.S102619. eCollection 2016.
Some studies favor elective cesarean delivery, and other surveys benefit vaginal delivery, while others emphasize that the quality of care during labor, birth, and immediate postpartum period plays a great role than the route of delivery. However, little information is locally available regarding the incidences of adverse birth outcome with respect to the route of delivery.
This study was a retrospective analysis of eligible patient records that included 3,003 pregnant women who had undergone either cesarean or vaginal delivery from July 1, 2012, to June 31, 2013. Pretested questionnaire was used to collect the data. The completeness and consistency of the data were checked, cleaned, and double entered to EPI-INFO 3.5.2 and analyzed with SPSS V20. Independent sample -test and chi-square test were conducted to compare the outcome of vaginal delivery and cesarean section (CS) using index variables. Significance was taken at <0.05.
Among the enrolled women, 760 mothers had CS delivery and the remaining 2,243 mothers delivered vaginally. Children born through CS (mean =6.83, standard deviation =1.31) had a significantly lower first-minute Apgar score than those in the vaginal delivery group (mean =7.19, standard deviation =1.18, =0.001). Similarly, the observed respiratory distress syndrome (=0.09, =0.793) and neonatal transfer rate to neonatal intensive care unit (=0.086, =0.766) were more in neonates delivered by CS than those in the vaginally delivered group. Besides, the observed neonatal death (=0.675, =0.411) and maternal death (= 8.878, =0.003) were higher among CS deliveries compared with vaginal deliveries.
Neonatal and maternal morbidity and mortality appear to be more in CS than in vaginal delivery. Therefore, decision to perform CS should be based on clear, compelling, and well-supported justifications.
一些研究倾向于选择性剖宫产，其他调查则支持阴道分娩，而另一些研究强调分娩、生产及产后即刻护理的质量比分娩方式起更大作用。然而，关于分娩方式导致不良分娩结局的发生率，当地可获取的信息很少。
本研究对符合条件的患者记录进行回顾性分析，纳入了2012年7月1日至2013年6月31日期间接受剖宫产或阴道分娩的3003名孕妇。使用预先测试的问卷收集数据。对数据的完整性和一致性进行检查、清理，然后双录入EPI-INFO 3.5.2，并使用SPSS V20进行分析。采用独立样本t检验和卡方检验，使用指标变量比较阴道分娩和剖宫产的结局。显著性水平设定为<0.05。
在纳入的妇女中，760名母亲进行了剖宫产，其余2243名母亲经阴道分娩。剖宫产出生的儿童（平均值=6.83，标准差=1.31）1分钟阿氏评分显著低于阴道分娩组的儿童（平均值=7.19，标准差=1.18，P=0.001）。同样，剖宫产分娩的新生儿中观察到的呼吸窘迫综合征（P=0.09，χ²=0.793）和转入新生儿重症监护病房的新生儿转运率（P=0.086，χ²=0.766）高于阴道分娩组。此外，剖宫产分娩的新生儿死亡（P=0.675，χ²=0.411）和孕产妇死亡（P=8.878，χ²=0.003）高于阴道分娩。
剖宫产的新生儿和孕产妇发病率及死亡率似乎高于阴道分娩。因此，剖宫产的决定应基于明确、令人信服且有充分依据的理由。
