剖宫产及其决定因素:孟加拉国杰索尔地区的一项基于医院的研究。
Cesarean delivery and its determining factors: A hospital-based study in Jashore District, Bangladesh.
作者信息
Hossain Md Sakhawot, Shuvo Suvasish Das, Asha Sharmin, Chodhoury Md Raihan, Elahi Md Toufiq
机构信息
Department of Nutrition and Food Technology, Jashore University of Science and Technology, Jashore, 7408, Bangladesh.
Department of Physical Education and Sports Science, Jashore University of Science and Technology, Jashore, 7408, Bangladesh.
出版信息
Public Health Pract (Oxf). 2024 Nov 22;8:100558. doi: 10.1016/j.puhip.2024.100558. eCollection 2024 Dec.
BACKGROUND
The rising prevalence of cesarean deliveries (CD) is a major public health problem worldwide, especially in Bangladesh. This study aims to investigate the prevalence and factors associated with cesarean deliveries in the Jashore district of Bangladesh.
STUDY DESIGN
This cross-sectional study, conducted from December 2022 to February 2023 in Jashore district, Bangladesh, involved face-to-face interviews with 662 mothers during hospital visits.
METHODS
A pretested, structured, and validated questionnaire was employed to gather information on socioeconomic characteristics, obstetric history, maternal healthcare utilization, and factors influencing the choice of delivery method. Multinomial logistic regression models were employed to assess and predict determining factors influencing cesarean delivery.
RESULTS
The study revealed a high cesarean delivery (CD) prevalence of 70.5 %, exceeding the WHO-recommended threshold. Key socioeconomic factors associated with increased CD rates included rural residence, younger maternal age (15-20 years), nuclear family structure, and husbands in business. Additionally, private hospital deliveries, a history of previous CD, maternal self-preference, and doctor's influence were significant predictors of CD. The majority of participants believed CD enhances maternal safety (74.6 %) and alleviates pain (74.8 %).
CONCLUSION
The high rate of cesarean deliveries in Jashore highlights the need for public health interventions that improve access to quality maternal care and promote evidence-based decision-making. Reducing unnecessary cesarean procedures, particularly in private hospitals, and enhancing patient education can significantly improve maternal and neonatal health outcomes.
背景
剖宫产率不断上升是全球主要的公共卫生问题,在孟加拉国尤为突出。本研究旨在调查孟加拉国杰索尔地区剖宫产的患病率及相关因素。
研究设计
这项横断面研究于2022年12月至2023年2月在孟加拉国杰索尔地区进行,对662名母亲在医院就诊时进行了面对面访谈。
方法
采用经过预测试、结构化且经过验证的问卷,收集有关社会经济特征、产科病史、孕产妇医疗保健利用情况以及影响分娩方式选择的因素的信息。采用多项逻辑回归模型来评估和预测影响剖宫产的决定因素。
结果
研究显示剖宫产患病率高达70.5%,超过了世界卫生组织建议的阈值。与剖宫产率上升相关的关键社会经济因素包括农村居住、孕产妇年龄较小(15 - 20岁)、核心家庭结构以及丈夫从事商业活动。此外,在私立医院分娩、既往剖宫产史、孕产妇自身偏好以及医生的影响是剖宫产的重要预测因素。大多数参与者认为剖宫产可提高孕产妇安全性(74.6%)并减轻疼痛(74.8%)。
结论
杰索尔地区剖宫产率高凸显了开展公共卫生干预措施的必要性,这些措施可改善获得优质孕产妇护理的机会并促进基于证据的决策制定。减少不必要的剖宫产手术,尤其是在私立医院,并加强患者教育,可显著改善孕产妇和新生儿的健康结局。