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印度剖宫产分娩情况的变化:了解孕产妇健康问题及其相关预测因素。

Changing scenario of C-section delivery in India: Understanding the maternal health concern and its associated predictors.

作者信息

Roy Nivedita, Mishra Piyush Kumar, Mishra Vijay Kumar, Chattu Vijay Kumar, Varandani Souryakant, Batham Sonu Kumar

机构信息

Department of Implementation Research, Society for Applied Studies, 45, Vijay Mandal Enclave, Kalu Sarai, New Delhi, India.

Department of Community Medicine, Government Medical College, Khandwa, Madhya Pradesh, India.

出版信息

J Family Med Prim Care. 2021 Nov;10(11):4182-4188. doi: 10.4103/jfmpc.jfmpc_585_21. Epub 2021 Nov 29.

Abstract

BACKGROUND

Caesarean section (C-section) delivery is a serious maternal health concern in the long run. Notedly, there is a lack of studies dealing with understanding the ways and reasons of C-section deliveries becoming a public health issue in today's time in India and the measures to reduce the unnecessary caesarean sections. We have conducted this study to study the changes in the state-wise prevalence of C-section deliveries in India and understand C-section delivery's socioeconomic and biomedical predictors.

MATERIALS AND METHODS

The study uses data from the fourth and fifth rounds of the National Family Health Surveys (NFHS). The per cent differences in the C-section deliveries from NFHS-4 to NFHS-5 across the states were measured through relative changes. The association between the C-section delivery and socioeconomic and biomedical factors were assessed using multiple logistic regression.

RESULTS

This study revealed that the C-section deliveries are higher in the southern states than in the other parts of India. Literacy plays a vital role in C-section deliveries. The probabilities of C-section deliveries are more in 30-40 and 40 + years. The women belonging to the median wealth index category were more likely (OR-CI, 1.62 [1.55-1.66]) to undergo the C-section followed by the women from wealthy households (OR-CI, 1.46 [1.41-1.52]).

CONCLUSION

The Government's health policymakers should take the initiative to reduce the C-section section delivery by means of building maternal health literacy and awareness among women and the community so that its future implications can be minimised. It is crucial to formulate a mandate and implement it in the states where C-sections are too high through community health workers and primary care providers.

摘要

背景

从长远来看,剖宫产分娩是一个严重的孕产妇健康问题。值得注意的是,目前缺乏关于理解剖宫产分娩在当今印度成为公共卫生问题的方式和原因以及减少不必要剖宫产的措施的研究。我们开展这项研究是为了研究印度各邦剖宫产分娩患病率的变化,并了解剖宫产分娩的社会经济和生物医学预测因素。

材料与方法

本研究使用了第四轮和第五轮全国家庭健康调查(NFHS)的数据。通过相对变化来衡量各邦从NFHS - 4到NFHS - 5剖宫产分娩的百分比差异。使用多元逻辑回归评估剖宫产分娩与社会经济和生物医学因素之间的关联。

结果

本研究表明,印度南部各邦的剖宫产分娩率高于其他地区。识字率在剖宫产分娩中起着至关重要的作用。30 - 40岁及40岁以上的女性进行剖宫产分娩的概率更高。属于中等财富指数类别的女性比富裕家庭的女性更有可能(OR - CI,1.62 [1.55 - 1.66])接受剖宫产,富裕家庭女性的该比例为(OR - CI,1.46 [1.41 - 1.52])。

结论

政府的卫生政策制定者应主动通过提高妇女和社区的孕产妇健康素养及意识来减少剖宫产分娩,以便将其未来影响降至最低。通过社区卫生工作者和初级保健提供者在剖宫产率过高的邦制定并实施相关规定至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b9f2/8797113/58581a039f34/JFMPC-10-4182-g001.jpg

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