Sujon Md Sazzad Hossan, Sumon Imran Hossain, Ahmmad Junayed, Asif Md Shahanewaj, Hossain Md Moyazzem
Department of Statistics and Data Science, Jahangirnagar University, Savar, Dhaka, Bangladesh.
Department of Electrical & Electronic Engineering, Faculty of Engineering, Daffodil International University, Birulia, Savar, Dhaka, Bangladesh.
Womens Health (Lond). 2025 Jan-Dec;21:17455057251356806. doi: 10.1177/17455057251356806. Epub 2025 Aug 11.
BACKGROUND: Cesarean section delivery is a surgical way to safeguard maternal and neonatal health when medical risk is associated with delivering babies. Its rates have been increasing globally over the past few decades, with a significant rise recorded in low- and middle-income countries, which leads cesarean section to crucial public health concerns due to unnecessary surgical interventions and associated risks for maternal and neonatal. OBJECTIVES: This study aims to identify the socioeconomic and demographic determinants contributing to the higher likelihood of cesarean section deliveries among Bangladeshi mothers residing in urban areas. DESIGN: The initial survey employed a cross-sectional design to collect data. METHODS: This research examined the Bangladesh Demographic and Health Survey (BDHS) dataset to identify the cesarean section among urban mothers. It utilized the chi-square test to measure associations, the Boruta algorithm, and a multivariable logistic regression model with a forest plot. RESULTS: The study pointed out that urban mothers belonging in richer and richest families (adjusted odds ratio: 2.83, 95% confidence interval: 1.88-4.26 and adjusted odds ratio: 4.79, 95% confidence interval: 3.13-7.34) and higher educational attainment (adjusted odds ratio: 1.89, 95% confidence interval: 1.20-2.99) are significantly correlated with cesarean section. Divisional differences are also robust with the significance of Sylhet (adjusted odds ratio: 0.23, 95% confidence interval: 0.12-0.47) and Chottogram (adjusted odds ratio: 0.50, 95% confidence interval: 0.30-0.83) divisions. Media exposure (adjusted odds ratio: 1.54, 95% confidence interval: 1.27-1.87) and mothers gave birth at the age 20-24 and 25-34 (adjusted odds ratio: 1.67, 95% confidence interval: 1.31-2.14 and adjusted odds ratio: 3.15, 95% confidence interval: 2.03-4.89) are also highly significantly associated with the likelihood of cesarean section. Moreover, mothers working status (adjusted odds ratio: 0.53, 95% confidence interval: 0.43-0.65) and religion (adjusted odds ratio: 2.33, 95% confidence interval: 1.60-3.38) are also correlated with cesarean section. CONCLUSION: The study reveals socioeconomic and sociodemographic reasons associated with the increase in cesarean section rates among urban mothers in Bangladesh, highlighting the need for targeted interventions to mitigate cesarean section rates and improve maternal and neonatal health.
背景：剖宫产是在分娩存在医疗风险时保障母婴健康的一种手术方式。在过去几十年里，全球剖宫产率一直在上升，低收入和中等收入国家的上升幅度尤为显著，由于不必要的手术干预以及母婴相关风险，剖宫产已成为关键的公共卫生问题。 目的：本研究旨在确定居住在城市地区的孟加拉国母亲剖宫产可能性较高的社会经济和人口统计学决定因素。 设计：初始调查采用横断面设计来收集数据。 方法：本研究分析了孟加拉国人口与健康调查（BDHS）数据集，以确定城市母亲中的剖宫产情况。它利用卡方检验来衡量关联性、Boruta算法以及带有森林图的多变量逻辑回归模型。 结果：研究指出，来自较富裕和最富裕家庭的城市母亲（调整后的优势比：2.83，95%置信区间：1.88 - 4.26；调整后的优势比：4.79，95%置信区间：3.13 - 7.34）以及较高的教育程度（调整后的优势比：1.89，95%置信区间：1.20 - 2.99）与剖宫产显著相关。地区差异也很显著，锡尔赫特（调整后的优势比：0.23，95%置信区间：0.12 - 0.47）和吉大港区（调整后的优势比：0.50，95%置信区间：0.30 - 0.83）地区具有显著性。媒体曝光（调整后的优势比：1.54，95%置信区间：1.27 - 1.87）以及母亲在20 - 24岁和25 - 34岁分娩（调整后的优势比：1.67，95%置信区间：1.31 - 2.14；调整后的优势比：3.15，95%置信区间：2.03 - 4.89）也与剖宫产可能性高度显著相关。此外，母亲的工作状况（调整后的优势比：0.53，95%置信区间：0.43 - 0.65）和宗教信仰（调整后的优势比：2.33，95%置信区间：1.60 - 3.38）也与剖宫产相关。 结论：该研究揭示了孟加拉国城市母亲剖宫产率上升相关的社会经济和社会人口统计学原因，强调了需要有针对性的干预措施来降低剖宫产率并改善母婴健康。
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