{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2023,9,4]],"date-time":"2023-09-04T10:12:24Z","timestamp":1693822344121},"reference-count":18,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2020,12,16]],"date-time":"2020-12-16T00:00:00Z","timestamp":1608076800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100014477","name":"National Health Insurance Administration","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100014477","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Obstet and Gynaecol"],"published-print":{"date-parts":[[2021,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>The authors investigated the effect of rising cesarean rates on maternal and perinatal mortality and in neonatal morbidity in Hungary.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The authors searched the validated Hungarian National Health database of neonatal discharge records for ICD\u201010 codes: P0590 (growth restriction); P2010 (fetal hypoxia in labor); P2090 (intrauterine hypoxia); P2200 (respiratory distress syndrome); P2390 (congenital pneumonia); P2400 (meconium aspiration); P2850 (respiratory insufficiency); P3990 (neonatal infection); P9130 (cerebral irritability) and P9141 (cerebral depression) collected between 2006 and 2015. County\u2010specific number of deliveries, perinatal deaths, and data on the route of delivery from the national database were also collected. Controlling for regional disparities with Human Development Index was also performed. Logistic regression analysis was performed to identify determinants of early neonatal mortality.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>While cesarean section\u2010rate rose from 28.6% to 38.2% perinatal mortality stayed within the range between 7.8\u2030 and 6.1\u2030. Early (0\u20136\u2009days) neonatal mortality (NMR) of the whole country in 2006 was 2.8\u2030 and showed a significant decrease over the years to reach 1.7\u2030 in 2015. The rate of most neonatal morbidities decreased significantly. Controlled regression analysis proved that cesarean rates negatively influenced neonatal mortality rates.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The rise of the cesarean section rate in Hungary between 2006 and 2015 was associated with a detectable reduction of perinatal mortality and morbidity; however, the proportion of improvement in neonatal morbidity is far less than the increment in cesarean rate.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jog.14611","type":"journal-article","created":{"date-parts":[[2020,12,18]],"date-time":"2020-12-18T03:48:34Z","timestamp":1608263314000},"page":"785-791","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Analysis of nationwide reflection of rising cesarean section rate in neonatal outcomes of Hungary"],"prefix":"10.1111","volume":"47","author":[{"given":"Robert","family":"P\u00f3ka","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, Faculty of Medicine University of Debrecen  Debrecen Hungary"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Olga","family":"T\u00f6r\u00f6k","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Faculty of Medicine University of Debrecen  Debrecen Hungary"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,12,16]]},"reference":[{"key":"e_1_2_7_2_1","first-page":"436","article-title":"Appropriate technology for birth","volume":"2","author":"World Health Organization","year":"1985","journal-title":"Lancet"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1523-536X.2006.00118.x"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.13592"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1038\/jp.2017.36"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2011.05.006"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1002494"},{"key":"e_1_2_7_8_1","doi-asserted-by":"crossref","unstructured":"Editorial. Volume 393 ISSUE 10185 P2010 May 18 2019.","DOI":"10.1016\/S0140-6736(19)31086-4"},{"key":"e_1_2_7_9_1","unstructured":"United Nations.Human development indices and indicators: 2018 statistical update1:16."},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2015.15553"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.5694\/mja16.00832"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)31928-7"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)31930-5"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)31927-5"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(15)70094-X"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1038\/jp.2017.173"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2016.11.1038"},{"key":"e_1_2_7_18_1","unstructured":"OECD.Cesarean sections. [Cited 20 Aug 2019.] Available from URL:https:\/\/data.oecd.org\/healthcare\/caesarean-sections.htm"},{"key":"e_1_2_7_19_1","unstructured":"EuroPeristat.European Perinatal Health Report Core indicators of the health and care of pregnant women and babies in Europe in 2015.www.europeristat.com"}],"container-title":["Journal of Obstetrics and Gynaecology Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jog.14611","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jog.14611","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jog.14611","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,3]],"date-time":"2023-09-03T15:40:30Z","timestamp":1693755630000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1111\/jog.14611"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,12,16]]},"references-count":18,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2021,2]]}},"alternative-id":["10.1111\/jog.14611"],"URL":"https:\/\/doi.org\/10.1111\/jog.14611","archive":["Portico"],"relation":{},"ISSN":["1341-8076","1447-0756"],"issn-type":[{"value":"1341-8076","type":"print"},{"value":"1447-0756","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,12,16]]},"assertion":[{"value":"2020-02-22","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-12-05","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-12-16","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}