Petitti D, Olson R O, Williams R L
Am J Obstet Gynecol. 1979 Feb 15;133(4):391-7. doi: 10.1016/0002-9378(79)90058-9.
The cesarean section rate has been rising in California since 1965. In this article, we describe the trend in cesarean section rates in California from 1960 to 1975 in relation to maternal and infant variables. Approximately proportionate increases in cesarean section rates by infant birth weight and maternal race were found. Cesarean section rates for women under 20 years of age and for those of first parity have risen proportionately more than rates for other age and parity groups. We also found that cesarean section rates for births at gestational age's exceeding 42 weeks have risen proportionately more than rates for births at other gestational ages. Maternal mortality ratios associated with cesarean section were twice those associated with noncesarean births for the years 1973, 1974, and 1975. Possible explanations of the current cesarean section rate include an increase in indications for the procedure, use of the fetal monitor, and the current medical-legal climate. The potential problems that cesarean section may create for the mother and infant are higher rates of iatrogenic prematurity and respiratory distress and of maternal morbidity and mortality.
自1965年以来，加利福尼亚州的剖宫产率一直在上升。在本文中，我们描述了1960年至1975年加利福尼亚州剖宫产率与孕产妇和婴儿变量相关的趋势。发现剖宫产率随婴儿出生体重和孕产妇种族的增加大致成比例。20岁以下妇女和初产妇的剖宫产率上升幅度比其他年龄和产次组的剖宫产率上升幅度更大。我们还发现，孕龄超过42周的分娩剖宫产率上升幅度比其他孕龄的分娩剖宫产率上升幅度更大。1973年、1974年和1975年，与剖宫产相关的孕产妇死亡率是非剖宫产分娩的两倍。当前剖宫产率上升的可能原因包括该手术指征的增加、胎儿监护仪的使用以及当前的医疗法律环境。剖宫产可能给母亲和婴儿带来的潜在问题是医源性早产和呼吸窘迫的发生率更高，以及孕产妇发病率和死亡率更高。
