Programa de Pós-Graduação em Biociências e Saúde, Universidade do Oeste de Santa Catarina. R. Getúlio Vargas 2125, Bairro Flor da Serra. 89600-000 Joaçaba SC Brasil.
Programa de Pós-Graduação em Epidemiologia, Universidade Federal de Pelotas. Pelotas RS Brasil.
Cien Saude Colet. 2022 Aug;27(8):3307. doi: 10.1590/1413-81232022278.05742022. Epub 2022 May 4.
This study aimed to describe changes in cesarean section (C-section) prevalence from 2007 to 2019, in public and private sectors, according to maternal characteristics. We included all puerperal women who gave birth in Rio Grande, Rio Grande do Sul, Brazil, at years 2007, 2010, 2013, 2016 and 2019. A questionnaire was applied up to 48 hours after delivery. We assessed C-section rates over time and described the prevalence according to independent variables. Poisson regression was used. A total of 12.415 puerperal women were included. The prevalence of C-section increased between 2007-2013 (from 51.2% to 61.2%) and decreased between 2013-2019 (48.9% in 2019). This decrease was observed only in the public sector and was higher among the youngest (-10.0 percentual points) and high educated women (-10.3 percentual points). While in the private sector C-section occurrence increased even more (95.7% in 2019). In the public sector, women that were older, with a partner, primiparous, who performed prenatal care in the private system and with adequate prenatal assistance presented higher prevalence of C-section. In the private sector the prevalence was high independently of the maternal characteristics. In order to reduce C-section rates, efficient delivery care policies mainly focused on the private sector are necessary.
本研究旨在描述 2007 年至 2019 年期间，根据产妇特征，公共和私营部门剖宫产（C -section）的流行率变化。我们纳入了 2007 年、2010 年、2013 年、2016 年和 2019 年在巴西南里奥格兰德州里奥格兰德市分娩的所有产妇。在分娩后 48 小时内应用问卷。我们评估了随着时间的推移 C 剖率，并根据独立变量描述了流行率。使用泊松回归。共纳入 12415 名产妇。2007 年至 2013 年期间 C 剖率增加（从 51.2%增加到 61.2%），2013 年至 2019 年期间下降（2019 年为 48.9%）。这种下降仅在公共部门观察到，在最年轻的人群中（下降 10.0 个百分点）和高学历的女性中（下降 10.3 个百分点）更为明显。而在私营部门，C 剖发生率甚至更高（2019 年为 95.7%）。在公共部门，年龄较大、有伴侣、初产妇、在私立系统中进行产前护理和产前护理充分的女性 C 剖率较高。在私营部门，无论产妇特征如何，C 剖率都很高。为了降低 C 剖率，有必要制定有效的分娩护理政策，主要侧重于私营部门。
