Giaxi Paraskevi, Gourounti Kleanthi, Vivilaki Victoria, Metallinou Dimitra, Zdanis Panagiotis, Galanos Antonis, Lykeridou Aikaterini
Department of Midwifery, University of West Attica, Agioy Spyridonos 28, 12243 Egaleo, Greece.
Laboratory for Research of the Musculoskeletal System, School of Medicine, National and Kapodistrian University of Athens, 14561 Athens, Greece.
Healthcare (Basel). 2023 Jul 28;11(15):2158. doi: 10.3390/healthcare11152158.
Worldwide, the cesarean section rate has steadily increased from 6.7% in 1990 to 21.1% in 2018 and is expected to rise even more. The World Health Organization propose the adoption of the Robson classification system as a global standard for monitoring, evaluating, and comparing delivery rates. The purpose of the current study is to use the Robson classification system to investigate how, independently of medical factors, the day of the week and time of delivery may be related to the mode of birth. In the sample analysis, we included the records of 8572 women giving birth in one private health facility in Greece. Over 60% of deliveries during the study period were performed by cesarean section, 30.6% by vaginal delivery, and 8.5% of deliveries were performed by operative vaginal delivery. The results of this study indicate that the lowest birth rates are observed on Monday, Saturday, and Sunday. Nulliparous women with no previous cesarean delivery, with a singleton in cephalic presentation ≥37 weeks with spontaneous labor (group 1) are 73% more likely to deliver by cesarean section between 08:00 A.M. and 03:59 P.M. compared to those who give birth between 12:00 A.M. and 07:59 A.M. Also, multiparous women with a single cephalic term pregnancy and one previous cesarean section (group 5.1) are 16.7 times more likely to deliver by cesarean section in the morning compared to overnight deliveries. These results point out two non-clinical variables that influences the CS rate. The Robson classification system was a useful tool for the above comparisons.
在全球范围内，剖宫产率已从1990年的6.7%稳步上升至2018年的21.1%，预计还会进一步上升。世界卫生组织提议采用罗布森分类系统作为监测、评估和比较分娩率的全球标准。本研究的目的是使用罗布森分类系统来调查，在不受医学因素影响的情况下，一周中的日期和分娩时间与分娩方式之间可能存在何种关联。在样本分析中，我们纳入了希腊一家私立医疗机构中8572名分娩妇女的记录。研究期间，超过60%的分娩是通过剖宫产进行的，30.6%是阴道分娩，8.5%是通过阴道助产分娩的。本研究结果表明，周一、周六和周日的出生率最低。从未剖宫产的初产妇，单胎头先露≥37周且自然临产（第1组），与上午12:00至07:59分娩的产妇相比，在上午08:00至下午03:59之间剖宫产的可能性高73%。此外，有一次剖宫产史的单胎足月妊娠经产妇（第5.1组），上午剖宫产的可能性是夜间分娩的16.7倍。这些结果指出了两个影响剖宫产率的非临床变量。罗布森分类系统是进行上述比较的有用工具。
