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首页> 外文期刊>Journal of health economics >It's about time: Cesarean sections and neonatal health
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It's about time: Cesarean sections and neonatal health

机译：时间到了：剖腹产和新生儿健康

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Cesarean sections have been associated in the literature with poorer newborn health, particularly with a higher incidence of respiratory morbidity. Most studies suffer, however, from potential omitted variable bias, as they are based on simple comparisons of mothers who give birth vaginally and those who give birth by cesarean section. We try to overcome this limitation and provide credible causal evidence by using variation in the probability of having a c-section that is arguably unrelated to maternal and fetal characteristics: variation by time of day. Previous literature documents that, while nature distributes births and associated problems uniformly, time-dependent variables related to physicians' demand for leisure are significant predictors of unplanned c-sections. Using a sample of public hospitals in Spain, we show that the rate of c-sections is higher during the early hours of the night compared to the rest of the day, while mothers giving birth at the different times are similar in observable characteristics. This exogenous variation provides us with a new instrument for type of birth: time of delivery. Our results suggest that non-medically indicated c-sections have a negative and significant impact on newborn health, as measured by Apgar scores, but that the effect is not severe enough to translate into more extreme outcomes. (C) 2018 Elsevier B.V. All rights reserved.
机译：剖宫产在文献中与新生儿健康状况较差有关，特别是与呼吸系统疾病的发生率较高有关。但是，大多数研究都受到潜在的遗漏变量偏差的影响，因为它们是基于对阴道分娩的母亲和剖宫产的母亲进行的简单比较得出的。我们试图克服这一局限性，并通过使用剖宫产的可能性与母婴特征无关的变化来提供可靠的因果证据：一天中的时间变化。以前的文献记载，尽管自然界能够均匀地分布出生和相关问题，但是与医师对休闲的需求有关的时变变量是计划外剖腹产的重要预测指标。使用西班牙的一家公立医院样本，我们发现，在凌晨时分剖腹产的比例要高于一天中的其余时间，而在不同时间分娩的母亲的可观察特征相似。这种外在的变化为我们提供了一种新的出生类型的工具：分娩时间。我们的结果表明，以Apgar评分衡量，非医学性剖腹产对新生儿健康有负面影响和显着影响，但这种影响还不够严重，不足以转化为更极端的结果。 （C）2018 Elsevier B.V.保留所有权利。

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