Department of Epidemiology and Biostatistics, School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
Kintampo Health Research Centre, Research and Development Division, Ghana Health Service, Kintampo, Ghana.
BMC Pregnancy Childbirth. 2023 Apr 25;23(1):286. doi: 10.1186/s12884-023-05622-5.
Globally, the increasing rate of caesarean section (CS) delivery has become a major public health concern due to its cost, maternal, neonatal, and perinatal risks. In Ghana, the Family Health Division of the Ghana Health Service in 2016 opted to initiate a program to prevent the abuse of CS and identify the factors contributing to its increase in the country. This study aimed to determine the prevalence and factors influencing CS deliveries in the Kintampo Districts of Ghana.
The current study used secondary data from the Every Newborn-International Network for the Demographic Evaluation of Populations and their Health (EN-INDEPTH) project in Kintampo, Ghana. The outcome variable for this study is CS delivery. The predictor variables were socio-demographic and obstetric factors.
The prevalence of CS delivery in the study area was 14.6%. Women with secondary education were 2.6 times more likely to give birth by CS than those with primary education. Unmarried women were about 2.5 times more likely to deliver by CS compared to those who were married. There was an increasing order of CS delivery among women in the wealthy quintiles from poorer to richest. The likelihood of women with gestational ages from 37 to 40 weeks to give birth by CS was about 58% less compared to those with less than 37 gestational weeks. Women who had 4-7 and 8 or more antenatal care (ANC) visits were 1.95 and 3.5 times more likely to deliver by CS compared to those who had less than 4 ANC visits. The odds of women who have had pregnancy loss before to deliver by CS was 68% higher compared to women who have not lost pregnancy before.
Caesarean section delivery prevalence in the study population was within the Ghana Health Service and World Health Organization ranges. In addition to known socio-demographic and obstetric factors, this study observed that a history of pregnancy loss increased the chances of a woman undergoing a CS. Policies should aim at addressing identified modifiable factors to stem the rise in CS deliveries.
在全球范围内，剖宫产率的上升已成为一个主要的公共卫生问题，因为它涉及到成本、母婴、新生儿和围产期风险。在加纳，加纳卫生服务部的家庭健康司于 2016 年选择启动一项计划，以防止滥用剖宫产，并确定导致该国剖宫产率上升的因素。本研究旨在确定加纳金坦博地区剖宫产的流行率及其影响因素。
本研究使用了加纳金坦博地区的 Every Newborn-International Network for the Demographic Evaluation of Populations and their Health (EN-INDEPTH) 项目的二手数据。本研究的因变量是剖宫产分娩。预测变量为社会人口统计学和产科因素。
研究地区剖宫产的流行率为 14.6%。接受过中等教育的女性行剖宫产的可能性是接受过小学教育的女性的 2.6 倍。与已婚女性相比，未婚女性行剖宫产的可能性约高 2.5 倍。在富有五分位数的女性中，剖宫产的比例从贫穷到最富有呈递增趋势。在 37 至 40 周妊娠龄的女性中，行剖宫产的可能性比少于 37 周妊娠龄的女性低约 58%。接受 4-7 次和 8 次或更多次产前保健（ANC）就诊的女性行剖宫产的可能性分别是接受少于 4 次 ANC 就诊的女性的 1.95 倍和 3.5 倍。与未经历过妊娠丢失的女性相比，有过妊娠丢失史的女性行剖宫产的可能性高 68%。
研究人群的剖宫产分娩率在加纳卫生服务部和世界卫生组织的范围内。除了已知的社会人口统计学和产科因素外，本研究还观察到，妊娠丢失史增加了女性行剖宫产的几率。政策应旨在解决已确定的可改变因素，以遏制剖宫产率的上升。
