In recent years, the cesarean section rate has been high. Because of the lack of research on cesarean section without medical indication, the surgery is facing huge risks. To compensate for the lack of domestic-relate...In recent years, the cesarean section rate has been high. Because of the lack of research on cesarean section without medical indication, the surgery is facing huge risks. To compensate for the lack of domestic-related research, and help clinicians to weigh the pros and cons of cesarean section, the paper reviews the reasons for cesarean delivery on maternal request （CDMR） and the advantages and disadvantages of CDMR so as to put forward constructive advice.展开更多
Background Cesarean section births have been steadily increasing over the past decade and have become an epidemic in China. Cesarean delivery on maternal request is a major contributor to this upward trend, and there ...Background Cesarean section births have been steadily increasing over the past decade and have become an epidemic in China. Cesarean delivery on maternal request is a major contributor to this upward trend, and there has been of much concern about its impact on maternal and child health. Most of mothers believe that cesarean delivery on maternal request can improve the child＇s intelligence, but direct evidence is sparse. In this cohort study, we aimed to directly assess the impact of cesarean delivery on maternal request on childhood intelligence. Methods Intelligence quotient （IQ） of 4144 preschool children from 21 cities/counties of Zhejiang and Jiangsu province whose mothers were registered in a population-based perinatal surveillance program during 1993-1996 was assessed with Chinese Wechsler Young Children Scale of Intelligence （C-WYCSI） in 2000. The outcomes were full-scale IQ, verbal IQ, and performance IQ of C-WYCSI. Mode of delivery and covariates were obtained from the surveillance program. We estimated unadjusted and adjusted effects of cesarean delivery on maternal request and assisted vaginal delivery on IQ scores compared with spontaneous vaginal delivery using regression analysis. Results The mean full-scale, verbal, and performance IQ for all children was 99.3_＋16.1,93.6_＋17.7, and 105.3_＋14.3. In crude analysis, cesarean delivery on maternal request versus spontaneous vaginal delivery was associated with an increase of 3.9 （95% confidence interval, 0.6 to 7.2） points in full-scale IQ, 4.8 （1.2 to 8.4） points in verbal IQ, and 2.4 （-0.6 to 5.3） points in performance IQ. After adjusting for maternal education, occupation, and IQ, the advantage was reduced to 1.6 （-1.3 to 4.5）, 2.3 （-0.8 to 5.5）, and 0.6 （-2.0 to 3.3） points for full-scale, verbal, and performance IQ, respectively. Assisted vaginal delivery versus spontaneous vaginal delivery was not associated with IQ scores in any analysis. Conclusion Neither cesarean delivery on maternal request nor assisted vaginal delivery affected children＇s IQ.展开更多
Despite the complications related to the caesarean section, some couples choose it by desirability. This study aimed to understand the reasons for maternal requests for a planned caesarean section in Burkina Faso, in ...Despite the complications related to the caesarean section, some couples choose it by desirability. This study aimed to understand the reasons for maternal requests for a planned caesarean section in Burkina Faso, in the absence of obstetric indications. A qualitative descriptive study was conducted in March 2019, consisting of twelve semi-structured interviews with women requesting caesarean section at Tingandogo Teaching Hospital in Burkina Faso. The operative reports were also examined. Thematic analysis based on Braun and Clarke approach was performed with QDA Miner software. Twelve patients were involved in the study. The mean age was 33 years. The majority had a higher level of education. Half were employees. The mean stay duration was 72 hours, with an estimated cost of CFA 300.000 (457,347 EUR). The choice of a planned caesarean was motivated by fear of birth (tokophobia), the positive feeling associated to the surgical technology, the doctor-patient relationship and the confidence in the quality of healthcare services such as reception and hygiene. Maternal reasons for requesting a planned caesarean section in Burkina Faso are multifactorial. Information, education and communication and shared decision-making strategies concerning the different modes of delivery and complications at the end of pregnancy, may contribute to reducing this problem.展开更多
文摘In recent years, the cesarean section rate has been high. Because of the lack of research on cesarean section without medical indication, the surgery is facing huge risks. To compensate for the lack of domestic-related research, and help clinicians to weigh the pros and cons of cesarean section, the paper reviews the reasons for cesarean delivery on maternal request （CDMR） and the advantages and disadvantages of CDMR so as to put forward constructive advice.
文摘Background Cesarean section births have been steadily increasing over the past decade and have become an epidemic in China. Cesarean delivery on maternal request is a major contributor to this upward trend, and there has been of much concern about its impact on maternal and child health. Most of mothers believe that cesarean delivery on maternal request can improve the child＇s intelligence, but direct evidence is sparse. In this cohort study, we aimed to directly assess the impact of cesarean delivery on maternal request on childhood intelligence. Methods Intelligence quotient （IQ） of 4144 preschool children from 21 cities/counties of Zhejiang and Jiangsu province whose mothers were registered in a population-based perinatal surveillance program during 1993-1996 was assessed with Chinese Wechsler Young Children Scale of Intelligence （C-WYCSI） in 2000. The outcomes were full-scale IQ, verbal IQ, and performance IQ of C-WYCSI. Mode of delivery and covariates were obtained from the surveillance program. We estimated unadjusted and adjusted effects of cesarean delivery on maternal request and assisted vaginal delivery on IQ scores compared with spontaneous vaginal delivery using regression analysis. Results The mean full-scale, verbal, and performance IQ for all children was 99.3_＋16.1,93.6_＋17.7, and 105.3_＋14.3. In crude analysis, cesarean delivery on maternal request versus spontaneous vaginal delivery was associated with an increase of 3.9 （95% confidence interval, 0.6 to 7.2） points in full-scale IQ, 4.8 （1.2 to 8.4） points in verbal IQ, and 2.4 （-0.6 to 5.3） points in performance IQ. After adjusting for maternal education, occupation, and IQ, the advantage was reduced to 1.6 （-1.3 to 4.5）, 2.3 （-0.8 to 5.5）, and 0.6 （-2.0 to 3.3） points for full-scale, verbal, and performance IQ, respectively. Assisted vaginal delivery versus spontaneous vaginal delivery was not associated with IQ scores in any analysis. Conclusion Neither cesarean delivery on maternal request nor assisted vaginal delivery affected children＇s IQ.
文摘Despite the complications related to the caesarean section, some couples choose it by desirability. This study aimed to understand the reasons for maternal requests for a planned caesarean section in Burkina Faso, in the absence of obstetric indications. A qualitative descriptive study was conducted in March 2019, consisting of twelve semi-structured interviews with women requesting caesarean section at Tingandogo Teaching Hospital in Burkina Faso. The operative reports were also examined. Thematic analysis based on Braun and Clarke approach was performed with QDA Miner software. Twelve patients were involved in the study. The mean age was 33 years. The majority had a higher level of education. Half were employees. The mean stay duration was 72 hours, with an estimated cost of CFA 300.000 (457,347 EUR). The choice of a planned caesarean was motivated by fear of birth (tokophobia), the positive feeling associated to the surgical technology, the doctor-patient relationship and the confidence in the quality of healthcare services such as reception and hygiene. Maternal reasons for requesting a planned caesarean section in Burkina Faso are multifactorial. Information, education and communication and shared decision-making strategies concerning the different modes of delivery and complications at the end of pregnancy, may contribute to reducing this problem.
