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卢旺达鲁瓦马加纳二级教学医院孕妇剖宫产分娩的患病率及相关因素

Prevalence and Factors Associated With Cesarean Section Delivery among Pregnant Women Attending Rwamagana Level Two Teaching Hospital, Rwanda.

作者信息

Uwingabire Jean Bosco, Gbadamosi Mojeed Akorede, Mochama Monica, Kubahoniyesu Theogene

机构信息

School of Public Health, Mount Kenya University, Kigali, Rwanda.

School of Public Health, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda.

出版信息

Rwanda J Med Health Sci. 2024 Nov 30;7(3):435-444. doi: 10.4314/rjmhs.v7i3.5. eCollection 2024 Nov.

Abstract

BACKGROUND

Cesarean section (CS) is an essential, life-saving procedure when clinically justified. However, exceeding the World Health Organization's recommended prevalence (10-15%) may lead to adverse outcomes. This study aimed to determine the prevalence of CS at Rwamagana Hospital and to assess the associated factors.

METHODS

This cross-sectional study was conducted among 426 postpartum women at Rwamagana Hospital. Data were analysed using the Statistical Package for the Social Sciences (SPSS). Descriptive statistics and multivariable logistic regression were employed. Statistical significance was set at a 5% level.

RESULTS

The results showed a 38% prevalence of CS. Women younger than 25 years were 9.51 times more likely to undergo CS compared to those aged 36-45 years (AO:9.51, 95% CI: 3.37-26.83, p < 0.001), Fetal malposition (AOR:106.8, 95% CI: 29.89-382.25, p < 0.001), experiencing no labour (AOR: 4.64, 95%CI: 1.71 - 12.63, p = 0.003), and first-time mothers (Parity=1) (AOR: 19.65, 95%CI: 8.91-43.33, p<0.001) were positively associated with CS. However, Previous vaginal birth reduced the odds of CS by 89% (AOR:0.11, 95% CI: 0.06-0.21, p < 0.001).

CONCLUSION

The prevalence of CS at Rwamagana Hospital exceeds the WHO recommendation. There is a need for enhanced community education to support safe vaginal deliveries.

摘要

背景

剖宫产在临床合理时是一项重要的救命手术。然而,超过世界卫生组织建议的患病率(10 - 15%)可能会导致不良后果。本研究旨在确定鲁瓦马加纳医院剖宫产的患病率,并评估相关因素。

方法

本横断面研究在鲁瓦马加纳医院的426名产后妇女中进行。使用社会科学统计软件包(SPSS)对数据进行分析。采用描述性统计和多变量逻辑回归分析。统计学显著性设定为5%水平。

结果

结果显示剖宫产患病率为38%。与36 - 45岁的妇女相比,25岁以下的妇女接受剖宫产的可能性高9.51倍(调整后比值比:9.51,95%置信区间:3.37 - 26.83,p < 0.001),胎位异常(调整后比值比:106.8,95%置信区间:29.89 - 382.25,p < 0.001)、未经历分娩(调整后比值比:4.64,95%置信区间:1.71 - 12.63,p = 0.003)以及初产妇(产次 = 1)(调整后比值比:19.65,95%置信区间:8.91 - 43.33,p < 0.001)与剖宫产呈正相关。然而,既往阴道分娩使剖宫产的几率降低了89%(调整后比值比:0.11,95%置信区间:0.06 - 0.21,p < 0.001)。

结论

鲁瓦马加纳医院剖宫产的患病率超过了世界卫生组织的建议。需要加强社区教育以支持安全的阴道分娩。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e6cd/12110475/e37070a597c1/RJMHS0703-0435Fig1.jpg

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