湖南省剖宫产率影响因素的多水平模型分析

Study on the Factors Related to Cesarean Section (CS) in Hunan Province by Two-level Models Analysis

目的探讨湖南省剖宫产率的影响因素及地市聚集性。方法随机抽取3000例分娩者的病案首页进行登记,分为剖宫产者和非剖宫产者进行单因素和两水平模型分析。结果在3000例分娩者中,剖宫产率为53.20%,非剖宫产率46.80%。剖宫产率从2004～2008年逐渐上升,且在湖南省14个地市不同,存在地市聚集性。两水平模型分析显示导致剖宫产率升高的因素中社会因素的影响强度为第1位,妊娠并发症和胎儿宫内窘迫分别为第2位和第3位。结论目前湖南省各地市的剖宫产率均相当高,不仅和生物医学因素和人口学因素有关,还存在地市聚集性。

Objective To find out the prevalence of cesarean section （CS） and probe the factors associated with CS and the cities aggregation.Methods Check in 3000 homes of medical records randomly from all of Hunan Province and classify as Women with CS and women without CS.The study was made by univariate and two-level models analysis.Results Among 3000 childbirth women,1595 had CS （case group） with the prevalence rate of 53.20% and 1405（46.80%） had normal delivery （control group）.The prevalence has been increasing from 2000 to 2009 and different in fourteen cities in Hunan Province,showing the cities aggregation.The two-level models analysis suggests that the intensity sequence of factors arouse the CS prevalence are social factors,pregnancy combinations and fetal distress.Conclusion At present,the prevalence rate of cesarean section was rather high（53.20%） in Hunan Province.The high rate of CS was more likely to associate not only with abnormal biomedical factors,but also with some demographic factors,as well as existing the cities aggregation.It is necessary to take measures to reduce the unnecessary CS in Hunan Province.