初产妇选择剖宫产的影响因素

Influential Factors and Intervention Measures of Choosing Cesarean Section in Primipara

【目的】探讨初产妇选择剖宫产的影响因素。【方法】收集2013年1月至2015年12月在本院分娩的1280例初产妇临床资料，分析近三年本院初产妇选择剖宫产情况及相关影响因素，以便制定护理干预措施。【结果】1280例初产妇中有45．31％（580／1280）选择剖宫产，2013年、2014年、2015年初产妇剖宫产率分别为31．17％、42．35％、59．57％，呈逐年递增趋势。经单因素分析显示，影响初产妇剖宫产的因素包括初产妇年龄、产妇体质量指数（BMI）、产妇文化程度、丈夫文化程度、家庭年收入、医疗保险方式、孕期合并症、产前接受自然分娩教育情况及既往病史等。经Logiskc多因素分析显示，产妇年龄〉35岁、产妇BMI〉25kg／m^2、产妇文化程度初中或以下、丈夫文化程度初中或以下、家庭年收入≥5万、孕期合并症是初产妇选择剖宫产的危险因素，而产前接受自然分娩教育则是初产妇选择剖宫产的保护因素。【结论】近年初产妇剖宫产率较高，影响剖宫产的因素与产妇身体状况、产妇及其丈夫文化程度、家庭收入等有关，临床应结合产妇实际情况对其进行针对性护理干预。

[Objective]To explore the factors influencing cesarean section in primipara and the intervention measures. [Methods]The clinical data of 1280 primiparous women who were delivered in our hospital from January 2013 to December 2015 were analyzed. The incidence of cesarean section and related influential factors in the first three years were analyzed, and nursing interventions were established. [Results]A total of 1,280 cases of primiparous women, 580 cases （45.31%） chose cesarean section. The rates of cesarean section in 2013, 2014 and 2015 were 31.17 %, 42.35% and 59.57% respectively. The univariate analysis showed that the factors influencing the cesarean section of the primiparas included the age of the primipara, the BMI, the ma- ternal education level, the husband＇s educational level, the family annual income, the medical insurance meth- od, the complication of pregnancy, Childbirth education and past medical history. Multivariate Logisitc analy- sis showed that maternal age〉 35 years, maternal BMI〉 25 kg/m^2, maternal education level junior high school or below, her husband education level junior high school or below, annual family income≥50,000 RMB and pregnancy complications were risk factors of the choice of cesarean section , while prenatal education of natural childbirth was the protective factor of cesarean section. [ConclusionIIn recent years, the rate of ce- sarean section is higher, and the factors influencing the cesarean section are related to the physical condition of the parturient, the education level of the mother and her husband, the family income and so on. Clinical prac- tice should be combined with the actual situation of the nursing intervention.