Federal University of Santa Catarina. Florianópolis, Santa Catarina, Brazil.
Federal University of Santa Catarina. CNPq researcher. Florianópolis, Santa Catarina, Brazil.
Midwifery. 2019 Dec;79:102530. doi: 10.1016/j.midw.2019.102530. Epub 2019 Aug 16.
This study aimed to examine the prevalence of spontaneous labour, induced labour and planned caesarean section in low-risk women; to identify the contribution of each group to the overall caesarean section rate; and to estimate factors associated with caesarean section in low-risk women according to spontaneous labour, induced labour and planned caesarean section.
Cross-sectional hospital-based study of postpartum women and newborns, using data from the survey Birth in Brazil, Southern region. In the sample of 2,668 low-risk women, a descriptive analysis was undertaken and a Multinomial Logistic Regression model was applied to verify associations among caesarean section and spontaneous labour, induced labour and planned caesarean section in comparison with vaginal birth.
The results showed the prevalence of spontaneous labour (48.0%), induced labour (14.0%) and planned caesarean sections (38.0%); these frequencies contributed to an overall caesarean section rate of 50.5%. Obstetric characteristics like previous vaginal birth or previous caesarean section were differentially associated with caesarean section, independently of the labour. Caesarean section without labour was significantly associated with age ≥ 35 years (ORadj 5.45 95%CI 3.16-9.39), economic class A and B (ORadj 3.10 95%CI 1.92-4.99), pregnancy between 37 and 38 weeks (ORadj 1.65 95%CI 1.22-2.24), same obstetrician in prenatal and childbirth (ORadj 13.83 95%CI 8.85-21.61) and private payment source at birth (ORadj 11.50 95%CI 6.64-19.93).
For low-risk women in Southern Brazil, the results identify high planned caesarean section rates, not associated with socioeconomic, obstetric, institutional or prenatal factors that justify these rates.
本研究旨在调查低危产妇中自发性分娩、诱导性分娩和计划性剖宫产的流行情况；确定每个组对总体剖宫产率的贡献；并根据自发性分娩、诱导性分娩和计划性剖宫产，估计与低危产妇剖宫产相关的因素。
这是一项基于医院的产后妇女和新生儿的横断面研究，使用了巴西南部地区生育调查的数据。在 2668 名低危产妇的样本中，进行了描述性分析，并应用多项逻辑回归模型来验证剖宫产与自发性分娩、诱导性分娩和计划性剖宫产之间的关联。
结果显示，自发性分娩（48.0%）、诱导性分娩（14.0%）和计划性剖宫产（38.0%）的流行率；这些频率导致总体剖宫产率为 50.5%。产科特征，如既往阴道分娩或既往剖宫产，与剖宫产独立相关，而与分娩无关。无分娩的剖宫产与年龄≥35 岁（ORadj 5.45 95%CI 3.16-9.39）、经济等级 A 和 B（ORadj 3.10 95%CI 1.92-4.99）、37 至 38 周妊娠（ORadj 1.65 95%CI 1.22-2.24）、产前和分娩期间的同一位产科医生（ORadj 13.83 95%CI 8.85-21.61）和出生时的私人支付来源（ORadj 11.50 95%CI 6.64-19.93）显著相关。
对于巴西南部的低危产妇，结果表明计划性剖宫产率较高，与 justifies 这些率的社会经济、产科、机构或产前因素无关。
