Abdulla Faruq, Hossain Md Moyazzem, Rahman Md Mahabubur, Rahman Md Siddikur, Rahman Azizur
Department of Applied Health and Nutrition, RTM Al-Kabir Technical University, Sylhet, Bangladesh.
Department of Statistics, Jahangirnagar University, Savar, Bangladesh.
Front Reprod Health. 2023 Feb 15;5:1101400. doi: 10.3389/frph.2023.1101400. eCollection 2023.
The key interest of this research is to identify the causes of the ongoing increasing trends in caesarean section or C-section (CS) deliveries in both urban and rural areas of Bangladesh.
This study analyzed all Bangladesh Demographic and Health Survey (BDHS) datasets through Chi-square and z tests and the multivariable logistic regression model.
CS deliveries were found to be more prevalent in urban than in rural areas of Bangladesh. Mothers above 19 years, above 16 years at first birth, overweight mothers, those with higher educational levels, those who received more than one antenatal care (ANC) visit, fathers having secondary/higher education degrees and employed as workers or in business, and mothers living in wealthy households in the cities of Dhaka, Khulna, Mymensingh, Rajshahi, and Rangpur divisions had a significantly higher likelihood of CS deliveries in urban areas. Contrastingly, mothers with ages between 20 and 39 years, above 20 years at first birth, normal weight/overweight mothers, those with primary to higher level of education, those in the business profession, fathers who also received primary to higher education, mothers who received more than one ANC visit, and those living in wealthy households in Dhaka, Khulna, Mymensingh, Rajshahi, and Rangpur divisions were more likely to have CS deliveries in rural areas. The 45-49 age group mothers had a five times higher likelihood of CS deliveries [odds ratio (OR): 5.39] in urban areas than in rural areas. Wealthy mothers were more likely to be CS-delivered in urban (OR: 4.84) than in rural areas (OR: 3.67).
The findings reveal a gradual upward alarming trend in CS deliveries with an unequal contribution of significant determinants in urban and rural areas of Bangladesh. Therefore, integrated community-level awareness programs are an urgent need in accordance with the findings on the risks of CS and the benefits of vaginal deliveries in this country.
本研究的主要关注点是确定孟加拉国城乡剖宫产（C 剖宫产）分娩持续上升趋势的原因。
本研究通过卡方检验、z 检验和多变量逻辑回归模型分析了所有孟加拉国人口与健康调查（BDHS）数据集。
研究发现，孟加拉国城市地区的剖宫产分娩比农村地区更为普遍。19 岁以上、初产时年龄在 16 岁以上的母亲、超重母亲、教育程度较高的母亲、接受过不止一次产前检查（ANC）的母亲、拥有中等/高等教育学位且受雇为工人或从事商业的父亲，以及居住在达卡、库尔纳、迈门辛、拉杰沙希和朗布尔分区城市富裕家庭的母亲，在城市地区进行剖宫产分娩的可能性显著更高。相比之下，年龄在 20 至 39 岁之间、初产时年龄在 20 岁以上的母亲、体重正常/超重的母亲、教育程度从小学到高等的母亲、从事商业职业的母亲、接受过小学到高等教育的父亲、接受过不止一次 ANC 检查的母亲，以及居住在达卡、库尔纳、迈门辛、拉杰沙希和朗布尔分区富裕家庭的母亲，在农村地区进行剖宫产分娩的可能性更大。45 - 49 岁年龄组的母亲在城市地区进行剖宫产分娩的可能性比农村地区高五倍[优势比（OR）：5.39]。富裕母亲在城市地区进行剖宫产分娩的可能性（OR：4.84）高于农村地区（OR：3.67）。
研究结果显示，孟加拉国城乡剖宫产分娩呈逐渐上升的惊人趋势，且重要决定因素的贡献不均衡。因此，根据该国剖宫产风险和阴道分娩益处的研究结果，迫切需要开展综合社区层面的宣传项目。
