Physician Cesarean Rate and Risk-Adjusted Birth Outcomes.

摘要

The cesarean section rate in the United States has been considered high by many experts, and efforts have been to lower the rate. However, the safety of a lower rate for the general population has not been investigated. A population-based, retrospective cohort study was conducted to examine this issue based on 171,295 singleton births that occurred in New Jersey hospitals between January 1, 1996 to December 31, 1997. Linked live birth/fetal death certificate data and hospital discharge data were used for the analysis. Physicians were divided into three groups based on their cesarean rate during the study period: low ( 27%). Perinatal mortality, rate of birth injury and uterine rupture were compared among the physician groups. Differences in patient risks were adjusted using multivariate model.