Center for Evidence-Based Global Health, Minna, Nigeria.
Warwick Centre for Global Health, Division of Health Sciences, University of Warwick, Coventry, UK.
Acta Paediatr. 2021 Oct;110(10):2780-2789. doi: 10.1111/apa.16032. Epub 2021 Jul 26.
To examine the factors associated with the risk of neonatal mortality following caesarean births at country-level in sub-Saharan Africa.
We used meta-analytic procedure to synthesize the results of most recent nationally representative cross-sectional Demographic and Health Survey (DHS) datasets for 33 sub-Saharan Africa countries conducted between 2010 and 2018. Pooled odds ratio (OR) and 95% confidence intervals (CI) were computed for all countries.
The overall caesarean section (CS) rate was 4.9%, neonatal mortality was 2.8% and Post-CS neonatal mortality was 4.3%. The rates of CS were generally low and only five countries had CS rates at or above 10%. The overall pooled result showed a statistically significant increase in the odds of neonatal mortality after a caesarean section (CS) OR 1.7 (95% CI 1.53 -1.89; I = 39.3%, p < 0.012); such that children delivered via CS were 70% more likely not to survive beyond the first 30 days. Geographical variations existed in the measure of association between caesarean section and neonatal mortality.
This paper has provided evidence on the low rates of CS and the associated neonatal mortality risk compared to normal deliveries in sub-Saharan Africa.
在撒哈拉以南非洲国家层面上，研究剖宫产分娩后新生儿死亡风险的相关因素。
我们使用荟萃分析程序，综合了 2010 年至 2018 年间在 33 个撒哈拉以南非洲国家进行的最新全国代表性横断面人口与健康调查（DHS）数据集的结果。计算了所有国家的汇总比值比（OR）和 95%置信区间（CI）。
总体剖宫产率为 4.9%，新生儿死亡率为 2.8%，剖宫产后新生儿死亡率为 4.3%。剖宫产率普遍较低，只有五个国家的剖宫产率达到或高于 10%。总体汇总结果显示，剖宫产后新生儿死亡的几率显著增加（OR 1.7，95%CI 1.53-1.89；I = 39.3%，p < 0.012）；即通过剖宫产分娩的儿童在头 30 天内死亡的可能性增加了 70%。在剖宫产与新生儿死亡率之间的关联程度上存在地域差异。
本文提供了撒哈拉以南非洲地区剖宫产率较低且与正常分娩相关的新生儿死亡风险的证据。
