初产妇剖宫产率升高的影响因素分析

Influencing Factors of Cesarean Section Rate of Primipara

目的了解初产妇剖宫产率升高的影响因素,寻找孕前、孕期干预办法,以降低剖宫产率。方法回顾性分析2019年1—6月在新乡市妇幼保健院进行阴道试产的共计851例初产妇临床资料,根据分娩结局分为试产成功组(719例)和试产失败组(132例)。比较两组临床资料,探讨各因素对分娩结局的影响。结果单因素分析结果显示:两组产妇年龄、孕周、产前体质量指数(BMI)、孕期家务劳动情况、孕期保健情况、新生儿体质量相比,差异有统计学意义(P<0.05),两组孕期增重、居住地、孕期工作情况、受教育程度相比,差异无统计学意义(P>0.05)。多因素logistic回归分析显示,产妇年龄、孕周、产前BMI、孕期增重、孕期家务劳动情况、新生儿体质量是阴道试产失败转剖宫产的影响因素(P<0.05)。结论产妇年龄、孕周、产前BMI、孕期增重、孕期家务劳动情况、新生儿体质量是阴道试产失败转剖宫产的影响因素。为降低初产妇剖宫产率,可鼓励已婚女性尽早生育,合理控制体重及孕期增重,孕期适当进行家务劳动,以争取阴道分娩机会,降低首次剖宫产率。

Objective To analyze the influencing factors of cesarean section rate in primiparas,and to find intervention methods before and during pregnancy to reduce the rate of cesarean section.Methods The clinical data of 851 primiparous women who underwent vaginal trial delivery in Xinxiang Maternal and Child Health Hospital from January to June 2019 were retrospectively analyzed.According to the outcome of childbirth,they were divided into successful trial delivery group(719 cases)and failing trial delivery group(132 cases).The clinical data of the two groups were compared,and the influence of various factors on the outcome of childbirth was explored.Results The univariate analysis showed that there were statistical differences between the two groups of maternal age,gestational age,prenatal body mass index(BMI),housework during pregnancy,health care during pregnancy,and weight of newborns(P<0.05).There was no statistical difference between the two groups in weight gain during pregnancy,residence,work during pregnancy,and education level(P>0.05).Multivariate logistic regression analysis showed that maternal age,gestational age,prenatal BMI,weight gain during pregnancy,housework during pregnancy,and newborn weight were the influencing factors for the failure of vaginal delivery(P<0.05).Conclusions Maternal age,gestational age,prenatal BMI,weight gain during pregnancy,housework during pregnancy,and newborn weight are the factors that influence the failure of vaginal delivery.In order to reduce the cesarean section rate of primiparas,we could encourage married women to give birth as soon as possible,reasonably control their weight and gain during pregnancy,and properly perform housework during pregnancy,to strive for vaginal delivery opportunities and reduce cesarean section rate of primiparas.