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作者

Zhang, Yiping Betrán, Ana Pilar Li, Xinhua Liu, Dengyuan Yuan, N. Shang, L. Lin, Wenlong Tu, S. Wang, Linhong Wu, X. Zhu, Tianying Zhang, Yuhong Lu, Zuxun Zheng, L. Gu, Chunyi Fang, J. Liu, Zheng Ma, L. Cai, Zhenyu Yang, Xi Li, Hongtian Zhang, Hongguang Zhao, Xiaoli Yan, L. Wang, Limin Sun, Xiaojie Luo, Q. Liu, Litao Zhu, Jun Qin, W. Yao, Q. Dong, S. Yang, Ying Cui, Z. He, Y. Feng, Xinglin He, L. Zhang, Haijun Zhang, Linxiu Wang, Xiaoli Souza, Joao Paulo Qi, Hongbo Duan, Tony Zhang, Jun

作者单位

Department of Obstetrics, The Maternal and Child Health Hospital of Xinxiang, Henan, China 13 Suining Central Hospital, Chongqing Medical University, Sichuan, China 26 Puyang Maternal and Child Care Centres, Henan, China Obstetrics and Gynaecology Hospital of Fudan University, Shanghai, China 34 The Second People’s Hospital of Qingyuan City, Guangdong, China Department of Obstetrics and Gynaecology, Southwest Medical University, Sichuan, China Department of Obstetrics, The Maternal and Child Health Hospital of Dalian, Liaoning, China 29 The Second People’s Hospital of Tongxiang, Zhejiang, China 14 Taizhou Hospital of Zhejiang Province, Zhejiang, China 31 Affiliated Hospital of Zunyi Medical University, Guizhou, China Department of Obstetrics and Gynaecology, The Second Hospital Affiliated to Shaanxi University of Chinese Medicine, Shaanxi, China Dongguan City Maternal and Child Health Hospital, Southern Medical University, Guangdong, China 38 Ministry of Education – Shanghai Key Laboratory of Children’s Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China 42 Department of Obstetrics, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, China 37 Department of Obstetrics, Eastern District of the Fourth Hospital of Hebei Medical University, Hebei, China 39 Department of Obstetrics and Gynaecology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China 15 Yangzhou Maternal and Child Care Service Centre, Jiangsu, China 18 Yanshi City People’s Hospital, Henan, China UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction, Department of Reproductive Health and Research, World Health Organization (WHO), Geneva, Switzerland 24 The Second Affiliated Hospital of Hebei North University, Hebei, China 30 The Central Hospital of Shaoyang, University of South China, Hunan, China 41 Department of Obstetrics and Gynaecology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China 35 Department of Obstetrics and Gynaecology, Fujian Medical University Union Hospital, Fujian Medical University, Fujian, China 27 Luzhou People’s Hospital, Sichuan, China 12 Department of Obstetrics, The Maternal and Child Health Hospital of Qujing, Yunnan, China 22 Haikou Hospital of the Maternal and Child Health, Hainan, China 33 Department of Obstetrics, The Maternal and Child Health Hospital of Cangzhou, Hebei, China Ministry of Education – Shanghai Key Laboratory of Children’s Environmental Health, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China 19 Department of Obstetrics and Gynaecology, Aviation Hospital of Beijing, China Medical University, Beijing, China 23 The First People’s Hospital of Taizhou, Wenzhou Medical University, Zhejiang, China 21 Yanan University Affiliated Hospital, Shaanxi, China 36 The People’s Hospital of Pengzhou, Sichuan, China 40 Department of Social Medicine, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, São Paulo, Brazil 20 Department of Obstetrics, The Maternal and Child Health Hospital of Luohu District, Shenzhen, China 10 Department of Obstetrics, Jiangsu Women and Child Health Hospital, Jiangsu, China 11 The First People’s Hospital of Zhaotong, Kunming Medical University, Yunnan, China 32 The First Affiliated Hospital of Anhui Medical University, Anhui, China 28 Affiliated Hospital of Jiangsu University, Jiangsu, China Department of Obstetrics and Gynaecology, The First Hospital Affiliated to Kunming Medical University, Yunnan, China 17 Department of Obstetrics, The Maternal and Child Health Hospital of Baoji, Shaanxi, China 25 Department of Obstetrics and Gynaecology, The 174th Hospital of the Chinese People’s Liberation Army, Xiamen University, Fujian, China 16 Qingdao Chengyang People’s Hospital, Shandong First Medical University, Shandong, China

刊名

BJOG: An International Journal of Obstetrics and Gynaecology

年份

2021

ISSN

1470-0328

摘要

Objective: To assess the current status of caesarean delivery in China, propose reference CD rates for China overall, and by regions, investigate the main indications for CDs and identify possible areas for safe reduction. Design: A multicentre cross-sectional study. Setting: A total of 94 hospitals across 23 provinces in China. Population: A total of 73 977 randomly selected deliveries. Methods: We used a modified Robson classification to characterise CDs in subgroups and by regions, and the W...更多

Objective: To assess the current status of caesarean delivery in China, propose reference CD rates for China overall, and by regions, investigate the main indications for CDs and identify possible areas for safe reduction. Design: A multicentre cross-sectional study. Setting: A total of 94 hospitals across 23 provinces in China. Population: A total of 73 977 randomly selected deliveries. Methods: We used a modified Robson classification to characterise CDs in subgroups and by regions, and the World Health Organization C-Model to calculate reference CD rates. Main outcome measures: CD rates in China. Results: In 2015–2016, the overall CD rate in China was 38.9% . Considering the obstetric characteristics of the population, the multivariable model-based reference CD rate was estimated at 28.5% . Accordingly, an absolute reduction of 10.4% may be considered. The CD rate varied substantially by region. Previous CD was the most common indication in all regions, accounting for 38.2% of all CDs, followed by maternal request , labour dystocia , fetal distress and malpresentation . Overall, 12.7% of women had prelabour CDs, contributing to 32.8% of the total CDs. Conclusions: Nearly 39% of births were delivered by caesarean in China but a reduction of this rate by a quarter may be considered attainable. Repeat CD contributed more than one-third of the total CDs. Given the large variation in maternal characteristics, region-specific or even hospital-specific reference CD rates are needed for precision management of CD. Tweetable abstract: The caesarean rate in 2015–2016 in China was 38.9%, whereas the reference rate was 28.5%.收起

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