“二孩政策”实施前后剖宫产率及剖宫产指征的变化分析

Changes of cesarean section rate and caesarean section indication before and after implementation of two-child policy

目的了解"单独二孩政策"实施前后成都市龙泉驿区妇幼保健院的剖宫产率及剖宫产指征的变化趋势。方法选取成都市龙泉驿区妇幼保健院2014年与2015年1到8月的1930份分娩病历资料进行回顾性分析。结果单独二孩政策实施前后,成都市龙泉驿区妇幼保健院剖宫产率分别是46.70%和52.17%(x^2=5.75,P=0.016<0.05),其中医学指征剖宫产所占比例分别是63.31%和82.07%(x^2=42.977,P=0.000<0.001),非医学指征剖宫产所占比例分别是36.69%和17.93%(x^2=60.537,P=0.000<0.001),差异均具有统计学意义。瘢痕子宫是剖宫产的最主要医学指征。结论单独二孩政策实施后,成都市龙泉驿区妇幼保健院的剖宫产率增加,其中医学指征剖宫产所占比例增加,非医学指征剖宫产所占比例降低。

Objective To understand the changes of cesarean section rate and cesarean section indication before and after implementation of two-child policy in one-child family. Methods Retrospective analysis was conducted on medical record data of 1 930 puerperas in Longquanyi District Maternal and Child Health Care Hospital of Chengdu from January 2014 to August 2015. Results Before and after the implementation of two-child policy, cesarean section rate in Longquanyi District Maternal and Child Health Care Hospital of Chengdu was 46.70% and 52.17%, respectively （X~ = 5.75, P = 0. 016 〈 0.05）, including 63.31% and 82.07% of cesarean section with medical indications （X2 = 42. 977, P = 0. 000 〈 0.001 ） and 36.69 % and 17.93 % without medical indications （X2 = 60. 537, P = 0. 000 〈 0.001 ）. All the differences were statistically significant. The most common indication of cesarean section was scar uterus. Conclusion The cesarean section rate in Longquanyi District Maternal and Child Health Care Hospital of Chengdu increases after the implementation of two-child policy. The ratio of cesarean section with medical indication increases, but that of cesarean section without medical indication decreases.