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首页> 外文期刊>Birth >Obstetric interventions, trends, and drivers of change: A 20‐year population‐based study from Iceland
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Obstetric interventions, trends, and drivers of change: A 20‐year population‐based study from Iceland

机译：产科干预措施，趋势和变革驱动因素：冰岛的一个20年的人口研究

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Abstract Background Population data on obstetric interventions is often limited to cesarean delivery. We aimed to provide a more comprehensive overview of trends in use of several common obstetric interventions over the past 2 decades. Methods The study was based on nationwide data from the Icelandic Medical Birth Register. Incidence of labor induction, epidural analgesia, cesarean, and instrumental delivery was calculated for all births in 1995‐2014. Change over time was expressed as relative risk ( RR ), using Poisson regression with 95% confidence intervals ( CI ) adjusted for several maternal and pregnancy‐related characteristics. Analyses were stratified by women's parity and diagnosis of diabetes or hypertensive disorder. Results During the study period, there were 81?389 intended vaginal births and 5544 elective cesarean deliveries. Among both primiparous and multiparous women, we observed a marked increase across time for labor induction (RR 1.78 [CI 1.67‐1.91] and RR 1.83 [CI 1.73‐1.93], respectively) and epidural analgesia (RR 1.40 [CI 1.36‐1.45] and RR 1.74 [CI 1.66‐1.83], respectively). A similar trend of smaller magnitude was observed among women with hypertensive disorders but no time trend was observed among women with diabetes. Incidence of cesarean and instrumental delivery remained stable across time. Discussion The use of labor induction and epidural analgesia increased considerably over time, while the cesarean delivery rate remained low and stable. Increases in labor induction and epidural analgesia were most pronounced for women without a diagnosis of diabetes or hypertensive disorder and were not explained by maternal characteristics such as advanced age.
机译：摘要背景填补产科干预措施通常限于剖宫产。我们的目标是在过去的二十年中提供使用几种常见产科干预措施的更全面的概况。方法该研究基于来自冰岛医疗出生寄存器的全国数据。为1995 - 2014年的所有出生都计算了劳动诱导，硬膜外镇痛，剖宫产和仪器交付的发病率。随着时间的推移而变化被表达为相对风险（RR），使用泊松回归具有95％的置信区间（CI）调整了几种母体和妊娠相关的特征。分析是由女性的奇偶阶段和诊断糖尿病或高血压障碍的分类。结果在研究期间，有81份预期的阴道出生和5544个选修剖宫产。在孕产量和多重妇女中，我们观察到劳动诱导时间的显着增加（RR 1.78 [CI 1.67-1.91]和RR 1.83 [CI 1.73-1.93]，硬膜外镇痛（RR 1.40 [CI 1.36-1.45]和RR 1.74 [CI 1.66-1.83]分别）。患有高血压障碍的女性中观察到较小幅度的类似趋势，但在患有糖尿病的女性中没有观察到时间趋势。剖腹产的发病率和工具递送仍然稳定。讨论随着时间的推移，使用劳动诱导和硬膜外镇痛的使用，而剖便率仍然低且稳定。劳动诱导和硬膜外镇痛的增加最为明显，没有诊断糖尿病或高血症病症的妇女，并且未被晚期的母体特征解释。

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