全面放开“二孩”政策前后广东省妇幼保健院住院孕产妇分娩情况分析

Analysis on hospital delivery situation before and after implementation of comprehensive two-child policy in Guangdong Provincial Maternal and Child Health Care Hospital

目的回顾性分析全面"二孩"政策放开前、后广东省妇幼保健院住院孕产妇分娩情况,为政策实施与临床诊疗安全提供依据。方法以2016年10月1日为界,2016年3-9月住院分娩的孕产妇定为政策开放前组(政前组),2016年10月-2017年4月住院分娩的孕产妇定为政策开放后组(政后组)。比较两组孕产妇的年龄、分娩量、"二孩"分娩率、早产率、剖宫产率、助产方式、妊娠期与产后并发症发生率等。结果政后组较政前组的高龄孕产妇、分娩量、"二孩"分娩率明显增加,瘢痕子宫率、吸引产率、妊娠期糖尿病率、胎盘早剥率明显增加,帆状胎盘/球拍状胎盘率明显增加,早产率、不良孕产史率明显减少,差异均有统计学意义(P<0.05)。结论全面"二孩"政策颁布后,住院分娩量、高龄孕产妇、妊娠期并发症增加,需要增加产科医务人员配备,加强医务人员继续教育,提高医疗技术水平。

Objective To retrospectively analyze hospital delivery situation before and after implementation of comprehensive two-child policy in Guangdong Provincial Maternal and Child Health Care Hospital,provide a basis for policy implementation and clinical practice.Methods Hospital delivery pregnant women from March to September in 2016 were selected as before policy implementation group,and hospital delivery pregnant women from October 2016 to April 2017 were selected as after policy implementation group.The clinical data of pregnant women in the two groups were compared,including age,hospital delivery quantity,birth rate of the second child,premature birth rate,cesarean section rate,midwifery methods,pregnancy and postpartum complications.Results Compared with before policy implementation group,the number of elderly parturient women,delivery quantity,and birth rate of the second child in after policy implementation group increased significantly,the incidence rates of scarred uterus,aspiration midwifery,gestational diabetes mellitus,placental abruption,and placenta velamentosa/battledore placenta increased significantly,the incidence rates of premature birth and adverse pregnancy history decreased significantly,there were statistically significant differences（P0.05）.Conclusion After implementation of comprehensive twochild policy,hospital delivery quantity,the number of elderly parturient women,and pregnancy complications increase.It is time to increase obstetric medical personnel,strengthen continuing education,and raise the level of medical technology.