论文部分内容阅读
剖腹产率的增加,已使人注意到人们对这种似乎与医学指征无关的手术选用不一。作者调查了居住在加利福尼亚州洛杉矶的不同人群分娩的245,854例单胎婴儿的首次剖腹产率与其社会经济状况之间的关系。 1982～1983年婴儿出生证所提供的资料揭示,首次剖腹产率与社会经济状况之间有明显的关系,而与产妇年龄,产次或婴儿出生体重无关。人口普查资料表明:在平均家庭收入超过3万美元的产妇中,首次剖腹产率为22.9％,而平均家庭收入低于1万美元的产妇中,首次剖腹产率为13.2％。在18～34岁的低收入组的产妇中,妊娠与分娩并发症的发生率为10.9％,在高收入组中则为17.4％(占两组首次剖腹产率差值的42％);在有并发症的产妇中,低收入组的首次剖腹产率为65.4％,而高收入组为79.3％(占两组差值的17％);无并发症的产妇中首次剖腹产率分别为6.4％和10.5％(占两组差值的41％)。首次剖腹产率以非西班牙裔的白种人最高(22.6％);亚裔美籍人(19.2％)与黑种人(18.9％)次之;而以墨西哥裔美籍人最低(13.9％)。从这四组中均可以观察到在首次剖腹产率上存在看明显的社会经济差异(P<0.01)。作者认为首次剖腹产率的高低直接与社会经济状况有关,而且这种相关性不能用产妇的年龄、产次,婴儿出生体重、种族以及妊娠、分娩并发症等方面的差异来解释。
The increase in the rate of Caesarean section has led to the attention that people use different procedures that seem to be unrelated to medical indications. The authors investigated the relationship between the first cesarean section rate and the socioeconomic status of 245,854 single-birth infants born in different populations living in Los Angeles, California. The data provided by the infant birth certificate from 1982 to 1983 revealed that there was a clear relationship between the first caesarean section rate and the socioeconomic status, but not with the maternal age, parity or birth weight. The census data showed that for the mothers whose average household income exceeded 30,000 U.S. dollars, the first rate of caesarean section was 22.9%, and among the mothers whose average family income was less than 10,000 U.S. dollars, the first rate of caesarean section was 13.2%. In the low-income group of 18 to 34-year-old women, the incidence of complications of pregnancy and childbirth was 10.9%, and in the high-income group it was 17.4% (42% of the difference between the first and the second group); Among the complications of maternal women, the first-time caesarean section rate was 65.4% in the low-income group and 79.3% in the high-income group (accounting for 17% of the difference between the two groups); the first-time caesarean section rate in the uncomplicated mothers was 6.4% and 10.5, respectively. % (41% of the difference between the two groups). The first time caesarean section rate was highest in non-Hispanic white people (22.6%); Asian Americans (19.2%) and black people (18.9%) followed, while Mexican-Americans were the lowest (13.9%). From these four groups, it can be observed that there is a significant socio-economic difference in the first caesarean section rate (P<0.01). The authors believe that the first time the rate of caesarean section is directly related to the socio-economic status, and this correlation can not be explained by the difference in maternal age, parity, birth weight, race, and complications of pregnancy and childbirth.