Title Cesarean delivery on maternal request in Southeast China
Authors Zhang, Jun
Liu, Yinghui
Meikle, Susan
Zheng, Junchi
Sun, Wenyu
Li, Zhu
Affiliation NICHHD, Epidemiol Branch, NIH, Bethesda, MD 20892 USA.
Peking Univ, Hlth Sci Ctr, Beijing 100871, Peoples R China.
NICHHD, Epidemiol Branch, NIH, Bldg 6100,Room 7B03, Bethesda, MD 20892 USA.
Keywords OUTCOMES
HEALTH
Issue Date 2008
Citation OBSTETRICS AND GYNECOLOGY.2008,111,(5),1077-1082.
Abstract OBJECTIVE: To estimate the incidence of overall cesarean delivery and cesarean delivery on maternal request in southeast China in the past decade. METHODS: We used data from a population-based maternal and child health surveillance system, which covers 21 cities and counties in two provinces in southeast China. We examined the rate of cesarean delivery and cesarean delivery on maternal request in 1.1 million singleton births from 1994 to early 2006. Cesarean delivery on maternal request was defined as a prelabor cesarean delivery for a singleton gestation without contraindications for vaginal delivery at 38 weeks of gestation or later. RESULTS: During the 13-year study period, the percentage of women who had high school or higher education increased from 13% to 46%. The overall cesarean rate increased from 22% in 1994 to 60% in 2003 and moderated to 56% in 2006. The corresponding rates of cesarean delivery on maternal request (per 100 all deliveries) were 0.8%, 22%, and 20%, respectively. The rates varied enormously among cities and counties. In some areas, cesarean delivery on maternal request accounted for half of all cesarean births. The patterns of rate change were diverse and uneven, and the pattern of risk factors changed substantially between 1994 and 2006. Nulliparity, higher education, older maternal age, having been delivered at provincial or county hospitals, and women's occupations were previously associated with rate of cesarean delivery on maternal request. The rate of cesarean delivery on maternal request no longer varies by age, hospital level, or occupation. CONCLUSION: The rate of cesarean delivery increased dramatically in southeast China in the past decade. Cesarean delivery on maternal request was the predominant contributor to the increase.
URI http://hdl.handle.net/20.500.11897/397248
ISSN 0029-7844
DOI 10.1097/AOG.0b013e31816e349e
Indexed SCI(E)
Appears in Collections: 医学部待认领

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