Gebreegziabher Hailu Areaya, Kebede Fanta Tsegaye, Tekulu Welay Fissaha, Etsay Assefa Natnael, Aregawi Hadera Surafel, Aregawi Gebremeskel Gebrekiros, Weldeslassie Gebremedhin Hagos, Asefa Guesh Gebreayezgi
Department of Public Health, Gamby Medical and Business College, Bahir Dar, Ethiopia.
Department of Midwifery, Adigrat University, Adigrat, Ethiopia.
Obstet Gynecol Int. 2020 Apr 20;2020:9018747. doi: 10.1155/2020/9018747. eCollection 2020.
The objective of this study was to assess the determinants of cesarean section deliveries in public hospitals of Addis Ababa, Ethiopia, 2019.
A hospital-based unmatched case-control study was conducted to study 780 (260 cases and 520 controls) women who delivered in public hospitals of Addis Ababa from August 22 to September 20, 2019. The cases were all mothers who delivered through caesarean section, and controls were all mothers who delivered vaginally in the same time in the study area. Data were collected from the randomly selected women and looking into their cards. Data were entered on EpiData 3.1 and exported to SPSS version 20 for cleaning and analyzing. Binary logistic regression and AOR with 95% CI were used to assess the determinants of caesarean section.
Majority of the study participants were in the age category 20-34 years. Nearly more than 1/3 of the participants (32.7% cases and 34.6% controls) have attended primary school. Most of the cases 217 (83.5%) and few of the controls 21 (4%) possess previous caesarean section. One hundred three (52.3%) of the cases and 329 (63.6%) controls were multi-parous. Previous caesarean delivery (AOR = 6.93, 95% CI; (3.39, 14.16)), singleton pregnancy (AOR = 0.34, 95% CI; (0.12, 0.83)), birth weight less than 2500 gm (AOR = 0.29, 95% CI; (0.18, 0.92)), birth weight greater than 4000 gm (AOR = 16.15 (8.22, 31.74)), completely documented partograph (AOR = 0.13, 95% CI; (0.078, 0.23)), and pregnancy-induced hypertension (AOR = 2.44, 95% CI; (1.46, 4.08)) were significant determinants of caesarean delivery in this study.
Previous caesarean section, number of delivery, birth weight, partograph documentation, and pregnancy-induced hypertension had significant association with caesarean section delivery in this study.
本研究的目的是评估2019年埃塞俄比亚亚的斯亚贝巴公立医院剖宫产分娩的决定因素。
进行了一项基于医院的非匹配病例对照研究，研究对象为2019年8月22日至9月20日在亚的斯亚贝巴公立医院分娩的780名女性（260例病例和520例对照）。病例为所有通过剖宫产分娩的母亲，对照为同期在研究区域内顺产的所有母亲。从随机选择的女性中收集数据并查看她们的病历。数据录入EpiData 3.1并导出到SPSS 20版本进行清理和分析。使用二元逻辑回归和95%置信区间的调整后比值比来评估剖宫产的决定因素。
大多数研究参与者年龄在20 - 34岁之间。近1/3以上的参与者（32.7%的病例和34.6%的对照）上过小学。大多数病例217例（83.5%）和少数对照21例（4%）有过剖宫产史。103例（52.3%）病例和329例（63.6%）对照为经产妇。既往剖宫产分娩（调整后比值比=6.93，95%置信区间；（3.39，14.16））、单胎妊娠（调整后比值比=0.34，95%置信区间；（0.12，0.83））、出生体重低于2500克（调整后比值比=0.29，95%置信区间；（0.18，0.92））、出生体重高于4000克（调整后比值比=16.15（8.22，31.74））、产程图记录完整（调整后比值比=0.13，95%置信区间；（0.078，0.23））以及妊娠高血压（调整后比值比=2.44，95%置信区间；（1.46，4.08））是本研究中剖宫产分娩的显著决定因素。
在本研究中，既往剖宫产史、分娩次数、出生体重、产程图记录以及妊娠高血压与剖宫产分娩有显著关联。
