Abstract:
BACKGROUND:Determinants of regional variation in caesarean sections can contribute explanations for the observed overall increasing trend of caesarean sections. We assessed which mechanism explains the higher rate of caesarean sections in the former West than East Germany: a more liberal use of caesarean sections in the case of relative indications or more common caesarean sections without indications. METHODS:We used a health insurance database from all regions of Germany with approximately 14 million insured individuals (about 17% of the total population in Germany). We selected women who gave birth in the years 2004 to 2006 and identified indications for caesarean section on the basis of hospital diagnoses in 30 days around birth. We classified pregnancies into three groups: those with strong indications for caesarean section (based on classification of absolute indications recommended by the Unmet Obstetrics Need network), those with moderate indications (other indications increasing the probability of caesarean section) and those with no indications. We investigated the percentage of caesarean sections among all births, presence of strong or moderate indications in all pregnancies, the probability of caesarean sections in the presence of indications and the fraction of caesarean sections attributable to strong, moderate and no indications. RESULTS:In total, 294,841 births from 2004-2006 were included in the analysis. In the former West Germany, 30% births occurred by caesarean section, while in the former East Germany the caesarean section rate was 22%. Proportions of pregnancies with strong and moderate indications for caesarean section were similar in both regions. For strong indications the probability of caesarean section was similar in East and West Germany, but the probability of caesarean section among women with moderate indications was substantially higher in the former West Germany. Caesarean sections were also more common among women with no indications in the former West (8%) than in the former East (4-5%). The higher probability of caesarean section in the case of strong or moderate indications in the former West than in the East explained 87% of the difference between section rates in these two regions, while caesarean sections without indications contributed to only 13% of the difference observed. CONCLUSIONS:The observed difference between caesarean section rates in the former East and West Germany was most likely due to different medical practice in handling relative indications.
journal_name
BMC Pregnancy Childbirthjournal_title
BMC pregnancy and childbirthauthors
Mikolajczyk RT,Schmedt N,Zhang J,Lindemann C,Langner I,Garbe Edoi
10.1186/1471-2393-13-99subject
Has Abstractpub_date
2013-05-01 00:00:00pages
99issn
1471-2393pii
1471-2393-13-99journal_volume
13pub_type
杂志文章abstract:BACKGROUND:Geophagy, a form of pica, is the deliberate consumption of soil and is relatively common across Sub-Saharan Africa. In Tanzania, pregnant women commonly eat soil sticks sold in the market (pemba), soil from walls of houses, termite mounds, and ground soil (kichuguu). The present study examined geophagy pract...
journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章
doi:10.1186/1471-2393-14-144
更新日期:2014-04-15 00:00:00
abstract:BACKGROUND:Perinatal health-seeking behaviours are influenced by various factors, including personal beliefs. South Asian women, who often live within a wide kinship system, can be influenced by the advice and guidance of their mothers and/or mothers-in-law. METHODS:To explore the cultural health perceptions of South ...
journal_title:BMC pregnancy and childbirth
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journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1186/s12884-019-2553-7
更新日期:2019-11-11 00:00:00
abstract:BACKGROUND:The stillbirth rate is an indicator of quality of care during pregnancy and delivery. Good quality care is supported by a functional heath system. The objective of this study was to explore the risk factors for stillbirths, particularly those related to a health system. METHODS:This case-control study was c...
journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章
doi:10.1186/s12884-018-1660-1
更新日期:2018-01-18 00:00:00
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journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章,多中心研究
doi:10.1186/1471-2393-14-137
更新日期:2014-04-10 00:00:00
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journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章
doi:10.1186/s12884-020-03395-9
更新日期:2020-11-19 00:00:00
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journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章
doi:10.1186/s12884-016-0865-4
更新日期:2016-04-11 00:00:00
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journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章
doi:10.1186/s12884-020-03396-8
更新日期:2020-12-02 00:00:00
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journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章
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更新日期:2013-02-06 00:00:00
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journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章
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更新日期:2020-08-17 00:00:00
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journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章
doi:10.1186/s12884-018-1718-0
更新日期:2018-04-06 00:00:00
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journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章
doi:10.1186/s12884-015-0486-3
更新日期:2015-03-05 00:00:00
abstract:BACKGROUND:Research on antenatal depressive, anxiety and stress symptoms among women with gestational diabetes mellitus (GDM) is lacking in Malaysia. This study aimed to determine the prevalence and factors associated with antenatal depressive, anxiety and stress symptoms among Malaysian women with GDM. METHODS:This w...
journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章,多中心研究
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更新日期:2019-10-21 00:00:00
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journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章
doi:10.1186/s12884-017-1351-3
更新日期:2017-06-06 00:00:00
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journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章
doi:10.1186/1471-2393-14-296
更新日期:2014-08-30 00:00:00
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journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章,meta分析
doi:10.1186/s12884-019-2689-5
更新日期:2019-12-30 00:00:00
abstract:BACKGROUND:The aim of the study was to assess whether a more context-specific modified version of WHO Safe Childbirth Checklist (mSCC) would result in improved adoption rate. METHODS:A prospective observational study was conducted in University Obstetrics Unit at De Soysa Hospital for Women (DSHW), Colombo and two Obs...
journal_title:BMC pregnancy and childbirth
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doi:10.1186/s12884-018-2040-6
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journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章,评审
doi:10.1186/s12884-016-0806-2
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journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章,随机对照试验
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更新日期:2014-08-14 00:00:00
abstract::BACKGROUND: In the Confidential Enquiry into Maternal Deaths (CEMD) Report, the very high risk of mortality in women who refuse blood transfusions is highlighted. The objectives were to establish current knowledge about, and views of transfusion in our pregnant population and to establish the level of compliance with ...
journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章
doi:10.1186/1471-2393-2-7
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更新日期:2017-12-20 00:00:00
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journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章
doi:10.1186/s12884-018-1915-x
更新日期:2018-07-04 00:00:00
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journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章
doi:10.1186/s12884-016-1157-8
更新日期:2016-11-21 00:00:00
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journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章
doi:10.1186/s12884-018-1824-z
更新日期:2018-05-23 00:00:00
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journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章
doi:10.1186/1471-2393-14-140
更新日期:2014-04-12 00:00:00
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journal_title:BMC pregnancy and childbirth
pub_type: 临床试验,杂志文章
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更新日期:2014-03-12 00:00:00
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pub_type: 杂志文章
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更新日期:2020-07-29 00:00:00
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journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章
doi:10.1186/s12884-020-2743-3
更新日期:2020-01-28 00:00:00
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journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章
doi:10.1186/1471-2393-14-277
更新日期:2014-08-15 00:00:00
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journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章
doi:10.1186/1471-2393-3-1
更新日期:2003-01-24 00:00:00