巴基斯坦剖宫产率趋势：来自 1990-2018 年人口与健康调查的二次数据分析。
Trends of caesarean section deliveries in Pakistan: secondary data analysis from Demographic and Health Surveys, 1990-2018.
机构信息
Institute of Social and Cultural Studies, University of the Punjab, Lahore, Pakistan.
Department of Public Health, Institute of Social and Cultural Studies, University of the Punjab, Lahore, Pakistan.
出版信息
BMC Pregnancy Childbirth. 2020 Dec 2;20(1):753. doi: 10.1186/s12884-020-03457-y.
BACKGROUND
Pakistan is among those countries where the number of caesarean section births has increased unusually in the past two decades. Therefore, the aim of the present study is to analyse the trend of caesarean section deliveries among child-bearing women (aged 15-49 years) in Pakistan and to identify maternal socio-demographic factors and pregnancy-related variables associated with the change in caesarean deliveries from 1990 to 2018.
METHODS
Secondary data from Pakistan Demographic and Health Surveys (1990-2018) were analysed. The analysis of data was confined to child-bearing mothers. Sample sizes were 4029, 5721, 7461 and 8287 for the time periods of 1990-91, 2006-07, 2012-13 and 2017-18, respectively. Socio-demographic information of the mothers and pregnancy-related variables were taken as independent variables for the present study. The association between independent variables and caesarean deliveries was measured in terms of unadjusted odds ratios (OR) and adjusted OR (AOR).
RESULTS
The percentages of the mothers who had at least one delivery during the 5 years prior to each survey who had caesarean deliveries increased continuously from 3.2% in 1990-91 to 19.6% in 2017-18. Results indicate that mothers over 24 years of age, located in Punjab, from the richest socio-economic class and living in urban areas were more likely to have delivered by caesarean section. Mothers with a first child in birth order and who had five and more children, as well as mothers who had more antenatal care visits and delivered babies in private hospitals showed a higher probability of caesarean section births.
CONCLUSIONS
The findings of the present study confirm the gradual upsurge in the percentage of mothers delivering by caesarean section during the past two decades in Pakistan. Against this backdrop, some measures need to be taken by health departments to regulate the number of caesarean deliveries. Awareness among women about pregnancy complications and elaborated details by gynaecologists about the medically indicated reasons for caesarean delivery are a few important steps in Pakistan that can help in reducing caesarean deliveries which are not medically indicated.
背景
在过去的二十年中，巴基斯坦的剖腹产分娩数量异常增加。因此，本研究旨在分析巴基斯坦生育年龄妇女（15-49 岁）的剖腹产分娩趋势，并确定与 1990 年至 2018 年剖腹产分娩变化相关的产妇社会人口统计学因素和与妊娠相关的变量。
方法
分析了巴基斯坦人口与健康调查（1990-2018 年）的二次数据。数据分析仅限于生育母亲。1990-91 年、2006-07 年、2012-13 年和 2017-18 年的样本量分别为 4029、5721、7461 和 8287。母亲的社会人口统计学信息和与妊娠相关的变量被视为本研究的自变量。使用未调整的优势比（OR）和调整后的优势比（AOR）来衡量自变量与剖腹产之间的关系。
结果
在每次调查前 5 年内至少有一次分娩的母亲中，剖腹产分娩的比例从 1990-91 年的 3.2%持续上升到 2017-18 年的 19.6%。结果表明，24 岁以上的母亲、位于旁遮普邦的母亲、来自最富有社会经济阶层的母亲和居住在城市地区的母亲更有可能进行剖腹产。在出生顺序中第一个孩子的母亲、生育了五个或更多孩子的母亲、接受了更多产前护理访问并在私立医院分娩的母亲，剖腹产分娩的可能性更高。
结论
本研究的结果证实了过去二十年中巴基斯坦剖腹产分娩比例的逐步上升。在此背景下，卫生部门需要采取一些措施来规范剖腹产分娩的数量。提高妇女对妊娠并发症的认识，并由妇科医生详细说明剖腹产分娩的医学指征，这是巴基斯坦减少不必要的剖腹产分娩的几个重要步骤。
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