中国妇女剖宫产率及其影响因素

Caesarean section rate and its influence factors in China

目的探讨近10年来我国妇女剖宫产率的变化趋势及影响因素。方法利用3次国家卫生服务调查资料进行单因素和多因素Logistic回归分析。结果1990～2003年我国剖宫产率快速上升，从1993年的6．73％（95％CI=5．99～7．47）上升到2003年20．55％（95％CI=19．50～21．60）。剖宫产率城乡差异大，2003年我国城乡剖宫产率分别是39．51％（95％CI=37．19～41．83）和12．77％（95％CI=11．75～13．79）；剖宫产率的上升速度农村明显高于城市，农村的上升速度是城市的2倍；影响剖宫产的非医学原因最主要的是城乡类别。结论我国城乡社会经济的快速发展是剖宫产率急剧上升的最重要间接原因。直接原因有待进一步探讨。

Objective To examine the caesarean section（CS）rate and its influence factors over past decade in China. Methods The univariate and multivariate analyses were used in the study using the national health services survey data. Results The CS rate in China increased rapidly in past decade from 6,7% （95% CI 5.99-7.47）in 1993 to 20.55% （95% CI 19.50-21.60） in 2003.There was a big difference of the CS rate between urban and rural areas. In 2003 the CS rate in urban and rural areas were 39.51% （95%CI 37.19-41.83） and 12.77% （95% CI 11.75-13.79） respectively;The speed of the increase in rural area was two times of that in urban areas. In addition to medical reasone, the main determinant of CS rate was type of urban or rural areas. Conclusion The rapid social economic development in China was main indirect cause of the increased CS rate in past decade, The direct determainants of the increased CS rate needed to be further explored.