Stafford R S, Sullivan S D, Gardner L B
School of Medicine, University of California, San Francisco.
Am J Obstet Gynecol. 1993 Apr;168(4):1297-302. doi: 10.1016/0002-9378(93)90384-u.
Our aim was to assess recent trends in cesarean section use in California.
California discharge abstract data on hospital deliveries in 1983 through 1990 (379,759 to 587,508 annual deliveries) were used to analyze time trends by indication, age, race, and payment source.
California cesarean section rates increased annually from 21.8% in 1983 to 25.0% in 1987 and then decreased to 22.7% by 1990. Similar patterns were noted for all age and race or ethnicity groups. Primary cesarean section rates increased from 15.2% in 1983 to 17.9% in 1987, then decreased to 16.2% by 1990. Declines in repeat cesarean section rates continued throughout 1983 through 1990, accelerating after 1987. For both primary and repeat cesarean section rates, time trends after mid-1987 were significantly different than those for 1983 to 1987.
After increasing from 1983 to 1987, California cesarean section rates declined from 1988 to 1990. Existing payment source differences in cesarean section use increased in magnitude from 1983 to 1990, with privately insured women consistently having the highest cesarean section rates.
我们的目的是评估加利福尼亚州剖宫产使用的近期趋势。
利用加利福尼亚州1983年至1990年（年分娩量从379,759例至587,508例）医院分娩的出院摘要数据，按指征、年龄、种族和支付来源分析时间趋势。
加利福尼亚州的剖宫产率从1983年的21.8%逐年上升至1987年的25.0%，然后到1990年降至22.7%。所有年龄组以及种族或族裔群体均呈现类似模式。初产妇剖宫产率从1983年的15.2%升至1987年的17.9%，然后到1990年降至16.2%。1983年至1990年期间，再次剖宫产率持续下降，1987年后加速下降。对于初产妇和再次剖宫产率，1987年年中之后的时间趋势与1983年至1987年的趋势显著不同。
1983年至1987年上升之后，加利福尼亚州的剖宫产率在1988年至1990年下降。1983年至1990年期间，剖宫产使用方面现有的支付来源差异在幅度上有所增加，私人保险女性的剖宫产率始终最高。
