Ahmed Anwar E, Mohammad Rouzait S
King Abdullah International Medical Research Center (KAIMRC), College of Public Health and Health Informatics, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.
Ambulatory Care Services, King Abdulaziz Medical City, Riyadh, Saudi Arabia.
Qatar Med J. 2019 Jul 25;2019(1):2. doi: 10.5339/qmj.2019.2. eCollection 2019.
Although cesarean delivery on maternal request (CDMR) has been associated with an increase in the frequency of cesarean sections (CSs), there is a lack of studies reporting the frequency of CDMR in Saudi Arabia. This study was conducted to estimate the prevalence of and the motives for CDMR and identify its associated factors. This cross-sectional study was conducted between March and June 2017 on 364 pregnant women who planned a CS at King Abdulaziz Medical City in Riyadh. The characteristics of the women and their motives for undergoing a CS for the current pregnancy term were collected. The prevalence of CDMR was found to be 13.7% (50/364) [95% confidence interval (CI): 10.370%-17.706%]. Older maternal age ( ≥ 40 years) [adjusted odds ratio (aOR) = 3.9; = 0.019], family history of CS (aOR = 2.9; = 0.038), non-Saudi nationality (aOR = 5.0; = 0.050), and receiving education or medical information about the possibility of delivering by CS (aOR = 13.7; = 0.030) were significantly associated with a higher prevalence of CDMR. As the number of previous CSs increased by one (aOR = 0.6; = 0.011), the odds of CDMR decreased by 40%. The most common motives for demanding a CS in the absence of medical indications were avoiding labor or possible complications from vaginal birth (60%) and fear of pain on vaginal delivery (46%). A high prevalence of CDMR was documented at King Abdulaziz Medical City, especially among women of older maternal age, having a family history of CS, of non-Saudi nationality, and who received education or medical information about the possibility of delivering by CS. Counseling programs might be helpful for pregnant women who fear pain in vaginal delivery or have had a previous traumatic birth experience.
尽管应产妇要求剖宫产（CDMR）与剖宫产（CS）频率增加有关，但沙特阿拉伯缺乏关于CDMR频率的研究报告。本研究旨在估计CDMR的患病率及其动机，并确定其相关因素。这项横断面研究于2017年3月至6月对利雅得阿卜杜勒阿齐兹国王医疗城计划进行剖宫产的364名孕妇进行。收集了这些女性的特征及其本次孕期进行剖宫产的动机。结果发现CDMR的患病率为13.7%（50/364）[95%置信区间（CI）：10.370%-17.706%]。产妇年龄较大（≥40岁）[调整后的优势比（aOR）=3.9；P=·0.019]、剖宫产家族史（aOR=2.9；P=0.038）、非沙特国籍（aOR=5.0；P=0.050）以及接受过关于剖宫产可能性的教育或医疗信息（aOR=13.7；P=0.030）与CDMR的较高患病率显著相关。随着既往剖宫产次数每增加一次（aOR=0.6；P=0.011），CDMR的几率降低40%。在无医学指征情况下要求剖宫产的最常见动机是避免分娩或阴道分娩可能出现的并发症（60%）以及害怕阴道分娩时疼痛（46%）。阿卜杜勒阿齐兹国王医疗城记录了较高的CDMR患病率，尤其是在产妇年龄较大、有剖宫产家族史、非沙特国籍以及接受过关于剖宫产可能性的教育或医疗信息的女性中。咨询项目可能有助于害怕阴道分娩疼痛或有过既往创伤性分娩经历的孕妇。
