2017—2020年福建省妇幼保健院剖宫产状况及影响因素

Cesarean section and its influencing factors in Fujian Maternity and Child Health Hospital in 2017—2020

目的探讨二孩政策实施后福建省妇幼保健院的剖宫率的变化情况及其影响因素,为降低福建省剖宫产率提供科学依据。方法利用福建省妇幼卫生系统,选取2017年1月—2020年10月在福建省妇幼保健院分娩的产妇初次产检信息,分析福建省妇幼保健院4年间剖宫产率的变化情况,同时采用多因素非条件logistics回归分析剖宫产的影响因素。结果福建省妇幼保健院4年间的平均剖宫产率为41.82%,2017年剖宫产率最高60.65%,2019年剖宫产率最低36.74%。2018—2020年剖宫产率有上升趋势。经产妇剖宫产率(45.32%)高于初产妇(36.68%)。在不同年龄产妇中,年龄≥35岁产妇剖宫产率最高(63.66%),年龄<25岁产妇剖宫产率最低(28.83%)。在不同体质量指数产妇中,肥胖组剖宫产率最高(63.49%),消瘦组剖宫率最低(32.96%)。在不同孕周的胎儿中,早产儿的剖宫产率(57.49%)高于非早产儿(40.32%)。多因素非条件logistics回归结果显示,产妇年龄越大、体质量指数越高、胎儿出生体质量越大、胎次越多及多胎妊娠的产妇更容易选择剖宫产。结论相对于2017年,2018年剖宫产率下降明显,2018—2020年剖宫产率有上升趋势。产妇年龄越大、体质量指数越高、胎次越多及多胎妊娠的剖宫产率越高;胎儿低出生体质量可能是剖宫产的影响因素。

Objective To discuss the change of cesarean section rate and its influencing factors in Fujian provincial maternity and child health hospital after the implementation of the second child policy.Methods The OB-GYN records of pregnant women who gave birth in Fujian provincial maternity and child health hospital from January 2017 to Uctober 2020 were retrieved from Fujian maternal and child health system and the change of cesarean section rate was analyzed.Multivariate non-conditional logistic regression model was used to analyze the influencing factors for cesarean section.Results The average cesarean section rate over the four year period was 41.82%with the highest of 60.65%in 2017 and the lowest of 36.74%in 2019.Pearsonχ2 test showed an upward trend in cesarean section rate from 2018 to 2020.The cesarean section rate was higher in postpartum women than that in primipara(45.32%vs 36.68%).The cesarean section rates were the highest among women aged≥35(63.66%)and women with overweight(63.49%)while were the lowest among women of younger than 25 years old(28.83%)and skinny women(32.96%).The cesarean section rate was much higher among women with non-term infants than that of those with term infants(57.49%vs 40.32%).Multivariate logistic regression analysis showed that pregnant women with older age,higher BMI,bigger fetus,multiple parity and with multi-fetus pregnancy were more likely to choose cesarean section.Conclusions The cesarean section rate drops significantly in 2018 compared to 2017.During 2018 and 2020,the cesarean section rate shows an upward trend.The rates increase in women with older age,higher BMI,multiple parity and multifetal pregnancy.Low birth weight may be the protective factor for cesarean section.