بررسی روند رو به رشد سزارین در ایران و جهان: مقاله مروری

نوع مقاله: مروری

نویسندگان

1 دانشجوی دکتری آموزش بهداشت و ارتقاء سلامت، مرکز تحقیقات مراقبت‌های مادر و کودک، دانشکده بهداشت، دانشگاه علوم پزشکی هرمزگان، بندرعباس، ایران.

2 دانشیار گروه اپیدمیولوژی، مرکز تحقیقات عوامل اجتماعی در ارتقاء سلامت، دانشکده بهداشت، دانشگاه علوم پزشکی هرمزگان، بندرعباس، ایران.

3 متخصص زنان و زایمان، مرکز تحقیقات باروری و ناباروری، دانشکده پزشکی، دانشگاه علوم پزشکی هرمزگان، بندرعباس، ایران.

4 متخصص بهداشت باروری، مرکز تحقیقات مراقبت‌های مادر و کودک، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی هرمزگان، بندرعباس، ایران.

5 مرکز تحقیقات توسعه اجتماعی و ارتقاء سلامت، دانشکده بهداشت، دانشگاه علوم پزشکی کرمانشاه، کرمانشاه، ایران.

چکیده

مقدمه: میزان سزارین در کشورهای توسعه یافته و کشورهای در حال توسعه در حال افزایش است. با توجه به احتمال بروز عوارض ناشی از سزارین و اهمیت شناسایی روند رشد این روش زایمان، مطالعه مروری حاضر با هدف بررسی روند سزارین در ایران و جهان در مطالعات مختلف انجام شد.
روش‌کار: در این مطالعه مروری جمع‌آوری اطلاعات از طریق بانک‌های اطلاعاتی PubMed، Science Direct، CINAHL، SID، Iranmedex، Magiran، Web Of Sciense، Goolgle Scholar، Scopus با استفاده از کلمات‌کلیدیCesarean Section Rate ،Cesarean Section Prevalence ،Delivery ، Childhood ، Childbirth ، Relative Causes، Relative Frequency انجام شد. بازه زمانی در انتخاب مقالات از سال 1990 تا 2015 بود. در نهایت 45 مقاله وارد مطالعه شدند.
یافته‌ها: در سراسر جهان نرخ سزارین از 7/6% در سال 1990 به 1/19% در سال 2014 افزایش یافته است که نشان‌دهنده رشد 4/12% آن بوده است. میزان سزارین در کشورهای در حال توسعه 6/14% و در کشورهای توسعه یافته رشد 7/12% داشته است. همچنین میزان سزارین در ایالات متحده از 7/20% در سال 1996 به 8/32% در سال 2011 رسیده است. در ایران نیز میزان نرخ سزارین از 16% در سال 1364 به 60% در سال 1392 رسیده است.
نتیجه‌گیری: نرخ کنونی سزارین به جز برای کشورهای کمتر توسعه یافته به طور مداوم رو به افزایش بوده و بالاتر از مقدار قابل توجیح پزشکی می باشد. افزایش شیب‌دار و نامناسب بودن میزان سزارین، نشان دهنده یک مشکل بهداشتی در ایران بوده و نیازمند توجه مسئولان به این امر می باشد. از آنجا که عوامل اساسی متعددی در زمینه نیاز به زایمان سزارین وجود دارد، باید استراتژی‌های مختلف شامل بیمارستان دوستدار مادر، توسعه پروتکل‌های استاندارد، کلاس‌های آمادگی برای مادران، ماماها و متخصصین زنان، کارگاه‌های آموزشی برای متخصصین و ماماها به منظور جلوگیری از استفاده غیر ضروری از این روش به کار گرفته شود.

کلیدواژه‌ها


عنوان مقاله [English]

A survey of the growing trend of caesarian section in Iran and the world: a review article

نویسندگان [English]

  • Sakineh Dadipoor 1
  • Abdoulhosein Madani 2
  • Azin Alavi 3
  • Nasibeh Roozbeh 4
  • Ali Safari Moradabadi 5
1 PhD Student of Health Education and Health Promotion, Mother and Child Care Research Center, School of Public Health, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.
2 Associate Professor, Department of Epidemiology, Social Determinants in Health Promotion Research Center, School of Public Health, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.
3 Gynecologist, Fertility and Infertility Research Center, Faculty of Medicine, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.
4 Expert of Reproductive Health, Mother and Child Care Research Center, School of Nursing and Midwifery, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.
5 Social Development & Health Promotion Research Center, School of Public Health, Kermanshah University of Medical Sciences, Kermanshah, Iran.
چکیده [English]

Introduction: The rate of cesarean section is increasing in developing and developed countries. Due to the probability of side-effects of cesarean and the importance of knowing the growing trend of this type of delivery, this study was performed with aim to survey the trend of caesarian section in Iran and the world in different studies.
Methods: In this review article, data was collected through databases of PubMed, Science Direct, CINAHL, SID, Iranmedex, Magiran, Web of Science, Google Scholar, and Scopus using the keywords of Cesarean Section Rate, caesarian section prevalence, delivery, childhood, relative causes, relative frequency. Time duration for articles' selection was 1990 to 2015. Eventually, 45 articles were included in the study.
Results: Worldwide, the rate of cesarean increased from 6.7% in 1990 to 19.1% in 2014, which represents a 12.4% increase. Cesarean rates increased 14.6 % in developing countries and 12.7% in developed countries. The cesarean rate in the United States increased from 20.7% in 1996 to 32.8 % in 2011. In Iran, the caesarean rate increased from 16% in 1985 to 60% in 2013.
Conclusion: Current rate of cesarean section, except for less developed countries, is consistently increasing and is higher than what is considered medically justifiable. The steep increase and inappropriate rate of caesarean section represents a health problem in Iran and requires the attention of government officials. Since there are numerous factors about the need for caesarean section, various strategies including mother-friendly hospitals, development of standard protocols; preparation classes for mothers, midwives, and gynecologists, and workshops for specialists and midwives should be considered to avoid unnecessary use of this method.

کلیدواژه‌ها [English]

  • Cesarean delivery
  • Trends of changes
  • Maternal health
  • Iran
  • World
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