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剖宮產(chǎn)術(shù)大為增加

【?2007-07-11 發(fā)布?】 美迪醫(yī)訊
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最新一項研究表明最近20年選擇性和急癥剖宮產(chǎn)術(shù)的趨勢增加,并且不能用自然生產(chǎn)風險增加或其他指針來解釋。

澳大利亞Telethon兒童健康研究中心的研究人員和其他澳大利亞機構(gòu)回顧了1984到2003年西澳大利亞所有出生人員---超過430,000個案例,并分析了分娩的模式。此項研究中排除了其他類型和經(jīng)臀部分娩的案例。

研究發(fā)現(xiàn)從1984到2003年,選擇剖宮產(chǎn)術(shù)的比例從6%上升到13%,在同一時期急癥剖宮產(chǎn)術(shù)的比例上升了70%。研究人員把私人醫(yī)療保險的因素加入分析,他們發(fā)現(xiàn)有醫(yī)療保險的婦女選擇剖宮產(chǎn)術(shù)是不擁有者的3倍多,而急癥剖宮產(chǎn)術(shù)為對照組的1.34倍。這項研究刊登在2007年5月出版的英國婦產(chǎn)科學雜志。

母親對剖宮產(chǎn)術(shù)要求的程度對于剖宮產(chǎn)術(shù)比例的增加影響現(xiàn)在還未知。西澳大利亞大學婦嬰保健學校的Craig Pennell博士說,“結(jié)果的產(chǎn)生是多因素聯(lián)合的結(jié)果,并且反映出復雜的社會影響過程包括,臨床治療狀態(tài)、分娩前培訓、家庭與社會壓力、法律體系、住址附近是否能進行這種手術(shù),以及名人是否選擇剖宮產(chǎn)術(shù)所產(chǎn)生的榜樣效應(yīng)等?!?




Dramatic Increase in Caesarean Sections 

A new study has found an increasing trend in both elective and emergency caesarean section rates over the past 20 years that do not appear to be explained by increased risk or indication. 

Researchers at the Telethon Institute for Child Health Research (Perth, Australia) and other Australian institutions looked at all births in Western Australia between 1984 and 2003--more than 430,000 births--and analyzed the mode of delivery. The researchers excluded multiple and breech births. 

The study found that elective caesareans rose from 6% to 13% between 1984 and 2003, and during the same time, there had been a 70% increase in the number of emergency caesareans. When the researchers included private medical insurance into the analysis, they found that women who had medical insurance were more than three times as likely to have an elective caesarean section, and 1.34 times more likely to have an emergency c-section than those who were uninsured, even though pregnancy complications and obstetric problems which may need a caesarean section are higher in uninsured women. The study was published in the May 2007 issue of the British Journal of Obstetrics and Gynaecology. 

he degree to which maternal request accounts for the increase in caesarean sections isn’t known,?said co-author obstetrician Craig Pennell, M.D., from the School of Women’s and Infants’ Health at the University of Western Australia (Perth, Australia). 揟he reasons are likely to be multifactorial and reflect a complex social process affected by clinical status, obstetric practice and training, family and social pressures, the legal system, availability of technology, women’s requests and women’s role models, such as celebrity elective caesarean delivery.


    

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