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孟加拉国的剖宫产术(CS)分娩:一项全国代表性的横断面研究。

Caesarian section (CS) delivery in Bangladesh: A nationally representative cross-sectional study.

机构信息

Department of Statistics, Comilla University, Kotbari, Cumilla, Bangladesh.

Department of Pharmaceutical Chemistry, Faculty of Pharmacy, University of Dhaka, Dhaka, Bangladesh.

出版信息

PLoS One. 2021 Jul 15;16(7):e0254777. doi: 10.1371/journal.pone.0254777. eCollection 2021.

Abstract

A growing trend in the caesarian section (CS) for delivery is a threat to child health as well as maternal health. This study was conducted to identify the potential socioeconomic and demographic factors associated with CS delivery in Bangladesh. Data obtained from the Bangladesh Demographic and Health Survey (BDHS) 2014 has been used for this study. The prevalence of CS delivery among Bangladeshi mothers was 24% (Urban: 36.9%, Rural: 17.9%). A two-level logistic regression showed that mothers having delivery in the private sector or private hospital (adjusted odds ratio [AOR] = 38.70, 95% confidence interval [CI] = 29.58 to 50.62), mother's age 25-35 years (AOR = 1.73, 95% CI = 1.26 to 2.37), wealth index average (AOR = 1.61, 95% CI = 1.15 to 2.27) and rich (AOR = 1.80, 95% CI = 1.29 to 2.51), antenatal visit 1-2 (AOR = 2.31, 95% CI = 1.47 to 3.64) and ≥ 3 (AOR = 3.68, 95% CI = 2.35 to 5.76), overweight mothers (AOR = 1.44, 95% CI = 1.09 to 1.90), multiple births (AOR = 3.87, 95% CI = 1.15 to 12.58), husband's occupation professional/technical/managerial (AOR = 1.68, 95% CI = 1.15 to 2.47) were significantly more prone to CS delivery. Also, place of residence, number of family members, birth order, child's size during birth, and divisions of Bangladesh, were potentially associated with CS delivery. The current epidemiological findings and evidence suggest adopting and implementing some urgent clinical practices and strict guidelines in the healthcare system to avoid unnecessary CS delivery in Bangladesh.

摘要

剖宫产(CS)分娩呈上升趋势,这不仅对产妇健康构成威胁,也对儿童健康构成威胁。本研究旨在确定与孟加拉国 CS 分娩相关的潜在社会经济和人口统计学因素。本研究使用了 2014 年孟加拉国人口与健康调查(BDHS)的数据。孟加拉国母亲的 CS 分娩率为 24%(城市:36.9%,农村:17.9%)。两级逻辑回归显示,在私立部门或私立医院分娩的母亲(调整后的优势比 [AOR] = 38.70,95%置信区间 [CI] = 29.58 至 50.62)、母亲年龄 25-35 岁(AOR = 1.73,95% CI = 1.26 至 2.37)、平均财富指数(AOR = 1.61,95% CI = 1.15 至 2.27)和富裕(AOR = 1.80,95% CI = 1.29 至 2.51)、产前检查 1-2 次(AOR = 2.31,95% CI = 1.47 至 3.64)和≥3 次(AOR = 3.68,95% CI = 2.35 至 5.76)、超重母亲(AOR = 1.44,95% CI = 1.09 至 1.90)、多胎妊娠(AOR = 3.87,95% CI = 1.15 至 12.58)、丈夫职业专业/技术/管理(AOR = 1.68,95% CI = 1.15 至 2.47)的 CS 分娩风险显著增加。此外,居住地、家庭成员数量、出生顺序、出生时儿童大小以及孟加拉国各地区都与 CS 分娩有潜在关联。目前的流行病学发现和证据表明,需要在医疗保健系统中采取和实施一些紧急的临床实践和严格的指导方针,以避免在孟加拉国不必要的 CS 分娩。

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