尼日利亚拉各斯州公立医院急诊剖宫产的流行情况、影响因素和结局。

Prevalence, influencing factors, and outcomes of emergency caesarean section in public hospitals situated in the urban state of Lagos, Nigeria.

机构信息

School of Human Sciences, University of Greenwich, London, United Kingdom.

LSE Health, London School of Economics and Political Science, London, United Kingdom.

出版信息

Afr Health Sci. 2023 Jun;23(2):640-651. doi: 10.4314/ahs.v23i2.74.

DOI:10.4314/ahs.v23i2.74

PMID:38223597

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10782300/

Abstract

BACKGROUND

Caesarean section (CS) performed in an emergency can be life-saving for both the pregnant woman and her baby. In Nigeria, CS rates have been estimated to be 2.7% nationally, with the highest regional rate of 7.0% reported in the South-West of the country. Our objective in this facility-based retrospective cross-sectional study was to describe patterns and assess factors, obstetric indications, and outcomes of emergency CS in Lagos, Nigeria.

METHODS

Socio-demographic, travel, and obstetric data of pregnant women were extracted from case notes. Travel data was inputted in Google Maps to extract travel time from the pregnant women' home to the hospital. Univariate, bivariate and multivariable logistic regression analyses were conducted.

RESULTS

Of the 3,134 included pregnant women, 1,923 (61%) delivered via emergency CS. The odds of an emergency CS were significantly higher among women who were booked (OR=1.97, 95%CI 1.64-2.35), presented with obstructed labour (OR=2.59, 95%CI 1.68-3.99), pre-eclampsia/eclampsia (OR=1.67, 95%CI 1.08-2.56), multiple gestations (OR=2.71, 95%CI 1.72-4.28) and travelled from suburban areas (OR=1.43, 95%CI 1.15-1.78). There was an increasing dose-effect response between travel time to the hospital and emergency CS.

CONCLUSION

Optimisation of CS rates requires a multi-pronged approach during pregnancy and childbirth, with particular emphasis on supporting pregnant women living in the suburbs.

摘要

背景

紧急剖宫产术（CS）对母婴均具有救生作用。在尼日利亚，CS 率估计为全国 2.7%，该国西南部报告的最高区域率为 7.0%。在这项基于机构的回顾性横断面研究中，我们的目的是描述模式，并评估紧急 CS 的产科指征和结局。

方法

从病历中提取孕妇的社会人口统计学、旅行和产科数据。将旅行数据输入谷歌地图，以提取孕妇家到医院的旅行时间。进行了单变量、双变量和多变量逻辑回归分析。

结果

在 3134 名纳入的孕妇中，1923 名（61%）通过紧急 CS 分娩。与非紧急 CS 相比，有预约分娩（OR=1.97，95%CI 1.64-2.35）、出现梗阻性分娩（OR=2.59，95%CI 1.68-3.99）、先兆子痫/子痫（OR=1.67，95%CI 1.08-2.56）、多胎妊娠（OR=2.71，95%CI 1.72-4.28）和来自郊区（OR=1.43，95%CI 1.15-1.78）的妇女进行紧急 CS 的可能性显著更高。前往医院的旅行时间与紧急 CS 之间存在剂量反应关系。