Marmitt Luana P, Cordeiro Marcos F, Cesar Juraci A
Universidade Federal do Rio Grande (FURG), Rua General Osorio, Rio Grande, RS, 96201-900, Brazil.
Universidade do Oeste de Santa Catarina (Unoesc), Rua Getúlio Vargas, 2125-Bairro Flor da Serra, Joaçaba, SC, 89600-000, Brazil.
Matern Child Health J. 2022 Jun;26(6):1231-1238. doi: 10.1007/s10995-021-03291-4. Epub 2021 Nov 27.
This study aimed to measure the prevalence, to describe the trend over time, and to evaluate socioeconomic inequalities in the occurrence of episiotomies in 2007, 2010, 2013, and 2016 in the municipality of Rio Grande, in Southern Brazil.
We included all women who had vaginal delivery in each of the studied years. All the information was obtained through a questionnaire applied at maternity wards within 48 h after delivery. The outcome consisted of episiotomy. A chi-square test was used to evaluate the linear trend. Absolute and relative inequalities were assessed from household income and schooling of the women through the Slope Index of Inequality and Relative Index of Inequality, respectively.
This study included 4,521 parturients. The episiotomy rate in the period fell from 71.0% (95%CI: 68.4-73.5) in 2007 to 40.1% (95%CI: 37.3-42.8) in 2016, and it was more frequent among women with higher income and higher schooling. We observed a reduction in the rate of episiotomy in all income and schooling levels, and this was more evident among women in the lowest socioeconomic levels. Absolute inequality declined, while relative inequality remained unchanged.
Despite the significant reduction in the rate of episiotomy, its occurrence remains high. Women with higher income and education, therefore with lower risk for complications during childbirth, were the most frequently submitted to this procedure. Routine use of episiotomy must be reevaluated, especially among pregnant women with better socioeconomic status.
本研究旨在衡量巴西南部里奥格兰德市2007年、2010年、2013年和2016年会阴切开术的发生率，描述其随时间的变化趋势，并评估社会经济不平等情况。
我们纳入了各研究年份中所有经阴道分娩的女性。所有信息均通过产后48小时内在产科病房发放的问卷获得。观察指标为会阴切开术。采用卡方检验评估线性趋势。分别通过不平等斜率指数和不平等相对指数，根据女性的家庭收入和受教育程度评估绝对不平等和相对不平等。
本研究纳入了4521名产妇。该时期会阴切开术的发生率从2007年的71.0%（95%置信区间：68.4 - 73.5）降至2016年的40.1%（95%置信区间：37.3 - 42.8），且在收入较高和受教育程度较高的女性中更为常见。我们观察到所有收入和受教育程度水平的会阴切开术发生率均有所下降，在社会经济水平最低的女性中更为明显。绝对不平等有所下降，而相对不平等保持不变。
尽管会阴切开术的发生率显著降低，但其发生率仍然很高。因此，收入和教育水平较高、分娩并发症风险较低的女性是最常接受该手术的人群。必须重新评估会阴切开术的常规使用情况，尤其是在社会经济地位较好的孕妇中。
