Kassa Z Y, Debelo B T, Burayu E T, Azene G K
College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia.
Department of Midwifery, College of Medicine and Health Science, Ambo University, Ambo, Ethiopia.
Ethics Med Public Health. 2022 Oct;24:100840. doi: 10.1016/j.jemep.2022.100840. Epub 2022 Sep 1.
The increasing number of caesarean births worldwide concerns pregnant women, obstetric service providers, and the country's economy. Unnecessary caesarean childbirth increases childbirth complications and the cost of health care in low-income countries, including Ethiopia.
This study aims to assess caesarean birth and associated factors at the Sidama region public hospitals, Southern Ethiopia, 2020.
An institution-based cross-sectional study was conducted among 484 women who gave birth at public hospitals in the Sidama region. A multi-stage sampling technique was employed. The data were collected from 1st to 30th of July 2020 by face-to-face interviews using a semi-structured questionnaire (see Table S1: see supplementary materials associated with this article on line), and the wealth index was analysed by principal component analysis. Backward logistic regression used an adjusted odds ratio and a 95% confidence interval to assess the strength and association between the caesarean section and its associated factors. A -value of < 0.05 was used to declare statistical significance.
Caesarean childbirth in this study was 34.3%. In this study, partograph monitoring (AOR = 2.23, CI = 1.13, 4.38), previous caesarean birth (AOR = 3.21, CI = 1.28,8.17), having genital cutting/mutilation (AOR = 2.51, CI = 1.14,5.53), intermittent cardiotocography monitoring during childbirth (AOR = 2.3, CI = 1.14, 4.49), absence of companionship during delivery (AOR = 4.97, CI = 2.37, 10.43) and is not remembering the last normal menstrual period (AOR = 3.12, CI = 1.40,6.94) had increased the odds of caesarean birth.
Studies show that the prevalence of caesarean has alarmingly increased in both developed and developing countries. However, the magnitude of caesarean section differs from country to country and in rural and urban areas; the magnitude of caesarean section in this study is much higher than the WHO recommends threshold. The local health bureau and obstetric care providers should pay attention to the caesarean section and need intervention in partograph plotting, companionship, cardiotocography, and female genital mutilation.
全球剖宫产数量不断增加,这引起了孕妇、产科服务提供者以及国家经济的关注。在包括埃塞俄比亚在内的低收入国家,不必要的剖宫产会增加分娩并发症和医疗保健成本。
本研究旨在评估2020年埃塞俄比亚南部锡达马地区公立医院的剖宫产及其相关因素。
在锡达马地区公立医院分娩的484名妇女中进行了一项基于机构的横断面研究。采用多阶段抽样技术。2020年7月1日至30日通过面对面访谈使用半结构化问卷收集数据(见表S1:见本文在线补充材料),并通过主成分分析对财富指数进行分析。向后逻辑回归使用调整后的比值比和95%置信区间来评估剖宫产与其相关因素之间的强度和关联。P值<0.05用于判定统计学显著性。
本研究中的剖宫产率为34.3%。在本研究中,产程图监测(调整后比值比=2.23,置信区间=1.13,4.38)、既往剖宫产史(调整后比值比=3.21,置信区间=1.28,8.17)、有女性生殖器切割/ mutilation(调整后比值比=2.51,置信区间=1.14,5.53)、分娩期间间歇性胎心监护(调整后比值比=2.3,置信区间=1.14,4.49)、分娩时无陪伴(调整后比值比=4.97,置信区间=2.37,10.43)以及不记得末次正常月经日期(调整后比值比=3.12,置信区间=1.40,6.94)增加了剖宫产的几率。
研究表明,剖宫产的患病率在发达国家和发展中国家都惊人地增加了。然而,剖宫产的比例因国家以及城乡地区而异;本研究中的剖宫产比例远高于世界卫生组织建议的阈值。当地卫生局和产科护理提供者应关注剖宫产问题,需要在产程图绘制、陪伴、胎心监护以及女性生殖器切割方面进行干预。