社会因素剖宫产相关原因调查分析

Investigation and analysis on related causes for cesarean section due to social factors

目的：分析剖宫产产妇的精神心理、社会经济因素,有效降低社会因素剖宫产率。方法：采用回顾性分析,选取2014年5~8月在广州市妇女儿童医疗中心分娩的单胎、头位、无合并症的260例产妇进行匿名问卷调查,内容包括孕妇年龄、文化程度、收入、参加产前宣教的次数、分娩方式及其原因,对分娩的认知及无痛分娩相关知识掌握等。结果：收回有效问卷257份,结果显示,91人选择剖宫产,166人选择阴道分娩。剖宫产者其年龄、学历、收入以及其配偶收入均高于阴道分娩者,差异有统计学意义（P〈0.05）,其中剖宫产者中≥35岁者中占79.12%,阴道分娩者中多为中、低收入人群。剖宫产原因分别为剖宫产可选择孩子的出生时间（90.50%）、害怕自然分娩的疼痛（85.00%）、家人或朋友的建议（71.20%）、担心自然分娩失败再剖宫产受两重罪（68.50%）和剖宫产可以让小孩少受罪（55.6%）。选择剖宫产者参加孕妇学校的次数、了解＂无痛分娩＂的程度均小于阴道分娩产妇（P〈0.05）,对剖宫产并发症的了解程度高于阴道分娩者（P〈0.05）,认为使用＂无痛分娩＂后的疼痛程度高于阴道分娩者（P〈0.05）。结论：社会经济情况良好、妊娠年龄偏大,因担心疼痛、选择时辰等原因,是选择剖宫产的主要因素。通过增加产前宣教、鼓励阴道分娩、推行健康理念,以有效降低不必要的剖宫产发生。

Objective： To analyze the spiritual psychology and social economic factors of women after caesarean operation,so as to effectively reduce the rate of caesarean section due to social factors. Methods： The method retrospective analysis was adopted. 260 cases of women of single birth and head delivery,without complications,who gave birth to children in Guangzhou women and children＇s medical center from May to August 2014 were selected to receive anonymous questionnaire survey,with the contents including the age,education background,income,number of times of participation in prenatal education,delivery mode and reason,cognition to delivery,as well as the grasping of knowledge regarding painless childbirth. Results： Total 257 effective copies of questionnaire were taken back,showing that,91 selected caesarean section and 166 selected vaginal delivery. Those selecting caesarean section were superior to those selecting vaginal delivery in age,education background,income,and spouse＇s income,and the difference was of statistical significance（ P〈0. 05）,and among those selecting caesarean section,79. 12% were ≥35 years old,while those selecting vaginal delivery mostly had medium and low income. The causes for selection of caesarean section include： being able to select the childbirth time（ 90. 50%）,being afraid of the pain from natural delivery（ 85. 00%）,listening to the advice from families or friends（ 71. 20）,worrying about double pains in case of failure in natural delivery（ 68. 50）,and reducing the child＇s suffering（ 55. 6%）. Those selecting caesarean section were lower than those selecting vaginal delivery in number of times of participation in pregnancy schools and degree of understanding to＂painless delivery＂（ P〈0. 05）,higher than those selecting vaginal delivery in degree of understanding to caesarean section complications（ P〈0. 05）,and higher than those selecting vaginal delivery in degree of pain through＂painless delivery＂they think of（ P〈0. 05）. Conclusion： Good social and economic situation,older gestational age,worry of pain,and time selection were main factors for selection of caesarean section. Through increasing the prenatal education,encouraging prenatal education,and carrying out health idea,unnecessary caesarean section could be effectively reduced.