Department of Midwifery, Tallinn Health Care College, Tallinn, Estonia.
Institute of Family Medicine and Public Health, Faculty of Medicine, University of Tartu, Tartu, Estonia.
Acta Obstet Gynecol Scand. 2023 Aug;102(8):1007-1013. doi: 10.1111/aogs.14609. Epub 2023 Jun 21.
The number of cesarean sections (CSs) has grown steadily, but the underlying factors driving this increase remain unknown. Data from Medical Birth Registries were retrieved to analyze CS trends in Estonia and Finland during the period 1992-2016.
All births in Estonia (n = 356 063) and Finland (n = 1 437 234) were included. The differences between Estonia and Finland in five-year time periods for the total CS rate, and rates in Robson 1, 2, and 5 groups (R1, R2, R5) were analyzed by logistic regression. Total CS rates were adjusted for birthweight, parity, previous CS, gestational age, singleton pregnancy, cephalic position, induction, mother's age. R1; R2; R5 rates were adjusted for birthweight and mother's age.
In Estonia, the proportion of CSs increased from 6.5% to 21.0% and in Finland from 15.1% to 16.8% between 1992 and 2016. In 2016, Estonia and Finland remained within the target value with their R1 + 2 (Estonia 18%; Finland 16%) and R5 (Estonia 59%; Finland 42%) values.
Comparing Robson groups in different countries can shed light on divergent CS rates and to improve the quality of perinatal and obstetric care.
剖宫产（CS）的数量稳步增长，但导致这种增长的根本因素尚不清楚。本研究从医学出生登记处获取数据，以分析 1992-2016 年期间爱沙尼亚和芬兰的 CS 趋势。
本研究纳入了爱沙尼亚（n=356063）和芬兰（n=1437234）的所有分娩。通过逻辑回归分析了爱沙尼亚和芬兰在五个时间段内总 CS 率以及 Robson 1、2 和 5 组（R1、R2、R5）率的差异。总 CS 率根据出生体重、产次、既往 CS、胎龄、单胎妊娠、头位、引产、母亲年龄进行调整。R1、R2 和 R5 率根据出生体重和母亲年龄进行调整。
1992 年至 2016 年期间，爱沙尼亚 CS 的比例从 6.5%增加到 21.0%，芬兰从 15.1%增加到 16.8%。2016 年，爱沙尼亚和芬兰的 R1+2（爱沙尼亚 18%；芬兰 16%）和 R5（爱沙尼亚 59%；芬兰 42%）值仍在目标值范围内。
比较不同国家的 Robson 组可以了解不同的 CS 率，并改善围产期和产科护理的质量。
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