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坦桑尼亚育龄妇女剖宫产的患病率及相关因素:来自2022年坦桑尼亚人口与健康调查数据的证据

Prevalence and factors associated with caesarean section among Tanzanian women of reproductive age: evidence from the 2022 Tanzania demographic and health survey data.

作者信息

Nahayo Bonfils, Olorunfemi Gbenga, Ndayishimye Samuel, Nsanzabera Charles

机构信息

Reproductive Health Program, Pan African University Life and Earth Sciences Institute (Including Health and Agriculture) PAULESI, Ibadan, Nigeria.

Université Sagesse d'Afrique, Bujumbura, Burundi.

出版信息

BMC Public Health. 2025 Feb 27;25(1):794. doi: 10.1186/s12889-025-21967-2.

Abstract

BACKGROUND

Caesarean Section (CS) is one of the commonest surgical procedures worldwide. It is an important medical intervention for reducing the risk of poor perinatal outcomes. However, there was increased trends in CS in sub-Saharan Africa as maternal and neonatal mortality and morbidity remains high. This study aims to determine the prevalence and factors associated with CS rates in Tanzania.

METHODOLOGY

This was a secondary data analysis of 4,768 women of reproductive age (15-49) in Tanzania. The data utilized was from the Tanzania Demographic Health and Survey (TDHS) 2022. The factors associated with CS were identified using multivariable binary logistic regression.

RESULTS

Out of 4,768 women of reproductive age in Tanzania, 497 (10.4%) had CS. Attaining primary (Adjusted Odds Ratio (aOR): 1.79,95% CI 1.23-2.60), secondary (aOR:2.07,95% CI 1.36-3.14) and higher education (aOR: 2.35, 95% CI 1.08-5.12); having a husband/partner with higher education; being in richest household wealth quintile (aOR:1.98,95% CI (1.31-3.00), having a job (aOR:1.29, 95% CI: 1.05-1.58 and having attended more than 4 antenatal care (ANC) visits (aOR: 1.36, 95% CI: 1.11-1.67) were associated with a higher odds of undergoing CS compared to their respective counterparts. However, living in rural areas (aOR: 0.74, 95% CI:0.58-0.94), being multiparous women with 2-4 births (aOR: 0.67, 95% CI: 0.53-0.84) and 5 or more births (aOR: 0.44, 95% CI: 0.32-0.60) were associated with lower odds of CS.

CONCLUSION

The overall prevalence of CS among women of reproductive age in Tanzania was 10.4%. The highest educational level, husband/partner's educational attainment, household wealth quintile, type of residence, employment status, increased ANC number, and high parity were associated with CS. The CS prevalence is at the lower limit of the recommendation of the World Health Organisation of 10-15%. Further researches are necessary to highlight other barriers, facilitators and outcome of CSs in Tanzania to advise policy stakeholders.

摘要

背景

剖宫产是全球最常见的外科手术之一。它是降低围产期不良结局风险的一项重要医疗干预措施。然而,在撒哈拉以南非洲地区,剖宫产率呈上升趋势,而孕产妇和新生儿的死亡率及发病率仍然很高。本研究旨在确定坦桑尼亚剖宫产率的患病率及其相关因素。

方法

这是一项对坦桑尼亚4768名育龄妇女(15 - 49岁)的二次数据分析。所使用的数据来自2022年坦桑尼亚人口与健康调查(TDHS)。采用多变量二元逻辑回归确定与剖宫产相关的因素。

结果

在坦桑尼亚的4768名育龄妇女中,497人(10.4%)进行了剖宫产。与各自对照组相比,接受小学教育(调整后优势比(aOR):1.79,95%置信区间1.23 - 2.60)、中学教育(aOR:2.07,95%置信区间1.36 - 3.14)和高等教育(aOR:2.35,95%置信区间1.08 - 5.12);丈夫/伴侣接受高等教育;属于最富裕家庭财富五分位数(aOR:1.98,95%置信区间(1.31 - 3.00)),有工作(aOR:1.29,95%置信区间:1.05 - 1.58)以及产前检查(ANC)就诊次数超过4次(aOR:1.36,95%置信区间:1.11 - 1.67)的妇女进行剖宫产的几率更高。然而,居住在农村地区(aOR:0.74,95%置信区间:0.58 - 0.94)、生育2 - 4次的经产妇(aOR:0.67,95%置信区间:0.53 - 0.84)和生育5次及以上的经产妇(aOR:0.44,95%置信区间:0.32 - 0.60)进行剖宫产的几率较低。

结论

坦桑尼亚育龄妇女剖宫产的总体患病率为10.4%。最高教育水平、丈夫/伴侣的教育程度、家庭财富五分位数、居住类型、就业状况、产前检查次数增加以及高胎次与剖宫产有关。剖宫产患病率处于世界卫生组织建议的10 - 15%的下限。有必要进一步开展研究,以突出坦桑尼亚剖宫产的其他障碍、促进因素和结局,为政策制定者提供建议。

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