Departments of Neurology, All India Institute of Medical Sciences, New Delhi, India.
Department of Biostatistics, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia.
PLoS One. 2020 Mar 12;15(3):e0229906. doi: 10.1371/journal.pone.0229906. eCollection 2020.
Caesarean section is considered a relatively preferable and safe method of delivery as compared to normal delivery. Since the last decade, its prevalence has increased in both developed and developing countries. In the context of developing countries viz., South Asia (the highest populated region) and South-East Asia (the third-highest populated region), where a significant proportion of home deliveries were reported,however, the preference for, caesarean delivery and its associated factors are not well understood.
To study the caesarean delivery in the South and South-East Asian countries and to determine the factors associated with the preference for caesarean delivery.
Demographic and Health Survey Data on from ever-married women of nine developing countries of South and South-East Asia viz., Vietnam, India, Maldives, Timor-Leste, Nepal, Indonesia, Pakistan, Bangladesh, and Cambodia have been considered. Both bivariate and binary logistic regression models were used to estimate the propensity of a woman undergoing for caesarean delivery and to assess the influence of maternal socioeconomic characteristics towards the preference for caesarean delivery.
Obtained results have shown an inclination of caesarean delivery among urban than rural women and are quite conspicuous, but is found to be underestimated mostly among rural women. Caesarean delivery in general is mostly predisposed among women whose baby sizes are either very large or smaller than average, have a higher level of education and place of delivery is private medical institutions. The logistic regression also revealed the influence of maternal socioeconomic characteristics towards the preference for caesarean delivery. Based on nine South and South-East Asian countries an overall C-section prevalence of 13%, but based on institutional births its increase to 19%. The forest plot demonstrated that a significant inclination of C-section among urban than rural regions. In Meta-Analysis, very high and significant heterogeneity among countries is observed, but confirms that in terms of prevalence of C-section all of the countries follow independent pattern.
Study of seven urban and four rural regions of nine South and South- East Asian countries showed, a significant inclination towards the caesarean delivery above the more recent outdated WHO recommended an optimal range of 10-15%and are associated maternal socioeconomic characteristics. In order to control unwanted caesarean delivery, the government needs to develop better healthcare infrastructure and along with more antenatal care related schemes to reduce the risks associated with increased caesarean delivery.
与自然分娩相比，剖宫产被认为是一种相对更可取和安全的分娩方式。在过去十年中，无论是在发达国家还是发展中国家，剖宫产的比例都有所增加。在南亚（人口最多的地区）和东南亚（人口第三多的地区）等发展中国家，虽然报告了很大比例的家庭分娩，但人们对剖宫产的偏好及其相关因素还不太了解。
研究南亚和东南亚国家的剖宫产情况，并确定与剖宫产偏好相关的因素。
本研究考虑了来自南亚和东南亚 9 个发展中国家（越南、印度、马尔代夫、东帝汶、尼泊尔、印度尼西亚、巴基斯坦、孟加拉国和柬埔寨）已婚妇女的人口与健康调查数据。使用了单变量和二项逻辑回归模型来估计妇女进行剖宫产的倾向，并评估产妇社会经济特征对剖宫产偏好的影响。
研究结果表明，城市妇女比农村妇女更倾向于选择剖宫产，这一趋势非常明显，但在农村妇女中，这一趋势被低估了。一般来说，剖宫产更倾向于那些婴儿大小异常（过大或过小）、受教育程度较高和分娩地点是私立医疗机构的妇女。逻辑回归还揭示了产妇社会经济特征对剖宫产偏好的影响。根据 9 个南亚和东南亚国家的数据，总体剖宫产率为 13%，但基于机构分娩，这一比例上升到 19%。森林图显示，城市地区剖宫产的倾向明显高于农村地区。在荟萃分析中，观察到各国之间存在非常高且显著的异质性，但这也证实了，就剖宫产的流行率而言，所有国家都遵循独立的模式。
对来自南亚和东南亚 9 个国家的 7 个城市和 4 个农村地区的研究表明，与世界卫生组织（WHO）最近建议的 10-15%的最佳范围相比，剖宫产有明显的偏好，并且与产妇的社会经济特征有关。为了控制不必要的剖宫产，政府需要发展更好的医疗基础设施，并制定更多的产前保健相关计划，以降低与剖宫产增加相关的风险。
