تعیین روند 12 ساله زایمانهای سزارین و طبیعی در استان آذربایجان غربی و پیشبینی آن تا سال 1397

نوع مقاله: اصیل پژوهشی

نویسندگان

1 دانشجوی کارشناسی ارشد آمار زیستی، دانشکده علوم پزشکی، دانشگاه تربیت مدرس، تهران، ایران.

2 استاد گروه آمار زیستی، دانشکده علوم پزشکی، دانشگاه تربیت مدرس، تهران، ایران.

3 استادیار گروه مامایی، مرکز تحقیقات چاقی مادر و کودک، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی ارومیه، ارومیه، ایران.

4 رزیدنت بیماریهای پوست، دانشکده پزشکی، دانشگاه علوم پزشکی همدان، همدان، ایران.

چکیده

مقدمه: بررسی و پیش­بینی تغییرات زمانی زایمان­های سزارین و طبیعی در آینده می­تواند در آگاهی و سیاست­گذاری­های طرح تحول سلامت و شیوع و بروز مشکلات بهداشتی نقش بسزایی ایفا کند، بنابراین مطالعه حاضر با هدف تعیین روند و مدل­سازی سری زمانی در پیش­بینی زایمان­ها در استان آذربایجان­غربی انجام شد.
روش‌کار: مطالعه حاضر یک بررسی طولی در طی سال‌های 94-1383 در خصوص تعداد زایمان‌های طبیعی و سزارین در استان آذربایجان غربی است که به‌صورت ماهانه مورد بررسی قرار گرفت. برای نشان دادن روند و ارائه پیش­بینی برای 3 سال آینده زایمان­ها از مدل سری­های زمانی Box-Jenkins و روش­های تشخیص و ارزیابی آن استفاده شد. جهت برازش مدل­های مناسب در هر دو نوع زایمان، از نرم‌افزارهای آماری R و SPSS (نسخه 23) استفاده شد.
یافته­ها: بر اساس نتایج داده­های زایمان­ها طی 12 سال در استان، 4/37% زایمان­ها به روش سزارین و 6/62% به روش طبیعی بوده است. نتایج پیش­بینی برای 3 سال آینده از مدل­ها نیز نشان داد که تعداد سزارین حدود 9/0% در مقایسه با سال 1394 کاهش داشته و در مقابل، تعداد زایمان طبیعی 7/6% افزایش داشته باشد.
نتیجه­گیری: پیش­بینی حاصل از مد­ل­ها نشان داد سزارین نسبت به زایمان طبیعی دارای روند نسبتاً کاهشی است و حدود 1/37% تخمین زده شد که نشان­دهنده اقدامات وزارت بهداشت درمان در ترویج زایمان طبیعی است و همچنان از استاندارد سازمان جهانی بهداشت فاصله زیادی دارد.

کلیدواژه‌ها


عنوان مقاله [English]

Determination of a 12-year trend of cesarean surgery and vaginal delivery in West Azerbaijan Province of Iran and its prediction until 2018

نویسندگان [English]

  • Samad Moslehi 1
  • Anoshirvan Kazemnejad 2
  • Hamideh Mohaddesi 3
  • Haniyeh Karimi 4
1 M.Sc. Student of Biostatistics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.
2 Professor, Department of Biostatistics, Faculty of Medical Sciences, Tehran, Iran.
3 Assistant Professor, Department of Midwifery, Maternal and Childhood Obesity Research Center, School of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia, Iran.
4 Resident of Dermatology, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran.
چکیده [English]

Introduction: The investigation and prediction of changes in the trend of cesarean and vaginal delivery can play a significant role in awareness and policy-making on health promotion and prevalence and incidence of health problems. Therefore, the aim of this study was to determine the proper time series pattern and trend for the prediction of deliveries in West Azerbaijan province, Iran.
Methods: This longitudinal study was conducted during 2004-2013 through monthly recording of the number of vaginal deliveries and cesarean section in West Azarbaijan province. In order to model and forecast the delivery trend in the next 3 years, Box-Jenkins time series approach and its diagnosis and evaluation methods were employed. To fit the appropriate models for trend analysis in both types of deliveries, R and SPSS (version 23) statistical software were used.
Results: According to the delivery data in the province, 37.4% and 62.6% of the deliveries were cesarean sections and vaginal deliveries, respectively, during 12 years. The results of the time series forecasting model predicting the trend of deliveries in the next 3 years showed that the number of caesarean section would decrease by 0.9%, compared to that in 2013, while the vaginal delivery rate would increase by 6.7%.
Conclusion: Based on the results of the time series forecasting model, the rate of cesarean section is on a relatively decreasing trend, compared to that of the vaginal delivery and was estimated as about 37.1%. This is indicative of the actions of the Ministry of Health and Medical Education toward the promotion of vaginal delivery. However, this rate is still far from the WHO standard.

کلیدواژه‌ها [English]

  • Vaginal delivery
  • Cesarean surgery
  • Time series
  • Prediction
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