无医学指征剖宫产的相关因素分析

Analysis on related factors of cesarean section without medical indications

目的：探讨发生无医学指征剖宫产的主要原因。方法：选择该院2012年6月-2013年11月收治的足月待产孕妇360例,分为无医学指征行剖宫产者180例（无指征组）及自然分娩产妇180例（自然分娩组）。对产妇采取剖宫产的相关因素进行问卷调查,采用SPSS 17.0软件及Logistic回归方程进行统计学分析。结果：①无指征组及自然分娩组单因素分析：产妇年龄、产次、产妇倾向分娩方式、产妇家属倾向分娩方式、提前住院待产、产妇对分娩方式及过程的了解、其他产妇分娩方式的影响等因素比较,两组间差异有统计学意义（P〈0.05）。②无指征剖宫产的多因素Logistic回归分析：年龄、产次、提前住院待产、产妇倾向分娩方式、家属倾向分娩方式、产妇对分娩方式及过程的了解等因素与无指征剖宫产有关（P〈0.05）。结论：加强对孕产妇自然分娩的宣教,适宜的镇痛技术,着力提高产科医师的自然分娩技术将有利于降低无医学指正剖宫产率。

Objective： To explore the main causes of cesarean section without medical indications. Methods： A total of 360 full- term regnant women were selected from the hospital from June 2012 to November 2013, then they were divided into cesarean section without medical indication group and spontaneous labor group, 180 women in each group; the related factors of cesarean section were surveyed by a questionnaire investigation, SPSS 17. 0 software and Logistic regression equation were used for statistical analysis. Results： Univariate anal- ysis showed that there were statistically significant differences in maternal age, delivery times, maternal favorite delivery patterns, favorite delivery modes of their family members, hospital delivery, maternal understanding about delivery patterns and process and other influencing factors between the two groups （P 〈 0. 05） . Multivariate logistic regression analysis showed that maternal age, delivery times, hospital delivery, maternal favorite delivery patterns, favorite delivery modes of their family members and maternal understanding about delivery patterns and process were correlated with cesarean section without medical indications （ P 〈 0. 05） . Conclusion： Strengthening propaganda and education of spontaneous birth, using appropriate analgesia and improving spontaneous labor techniques of obstetricians are helpful to reduce cesarean section without medical indications.