Cesarean sections in Brazil: will they ever stop increasing? / Cesáreas en el Brasil: ¿dejarán de aumentar alguna vez?
Rev Panam Salud Publica
; 38(3),sept. 2015
Artigo
em Inglês
| PAHO-IRIS
| ID: phr-10077
Biblioteca responsável:
US1.1
ABSTRACT
Objective. To describe trends, geographic distribution, and risk factors for cesarean deliveries in Brazil in 2000–2011, and to determine if efforts to curtail rates have had a measurable impact. Methods. This was an observational study using nationwide information from the Department of Informatics of the Unified Health System (DATASUS). Individual level analyses were based on data regarding maternal education, age, parity, and skin color. Ecological analyses at the level of 431 health districts investigated the relationships with health facility density and poverty level. Results. Cesarean rates increased markedly, from 37.9% in 2000 to 53.9% in 2011. Preliminary results from 2012 showed a rate of 55.8%, with the richest geographic areas showing the highest rates. Rates at the municipal level varied from 9%–96%. Cesareans were more common in women with higher education, white skin color, older age, and in primiparas. In the ecological analyses, the number of health facilities per 1 000 population was strongly and positively correlated with cesarean rates, with an increase of 16.1 percentage points (95% Confidence Interval [95%CI] = 4.3–17.8) for each facility. An increase of 1 percentage point in the poverty rate was associated with a decline of 0.5 percentage point in cesarean rates (95%CI = 0.5–0.6). Conclusions. The strong associations with maternal education and health facility density suggest that the vast majority of cesareans are not medically indicated. A number of policies and programs have been launched to counteract this trend, but have had virtually no impact.
Texto completo:
Disponível
Coleções:
Bases de dados de organismos internacionais
Contexto em Saúde:
Agenda de Saúde Sustentável para as Américas
Problema de saúde:
Objetivo 11 Desigualdades e iniquidades na saúde
Base de dados:
PAHO-IRIS
Assunto principal:
Fatores Socioeconômicos
/
Brasil
/
Prova de Trabalho de Parto
/
Cesárea
/
Saúde da Criança
/
Saúde Materno-Infantil
/
Parto Obstétrico
/
Saúde Materna
Tipo de estudo:
Estudo observacional
/
Fatores de risco
Aspecto:
Determinantes sociais da saúde
/
Equidade e iniquidade
País/Região como assunto:
América do Sul
/
Brasil
Idioma:
Inglês
Ano de publicação:
2015
Tipo de documento:
Artigo