初产妇经阴分娩的影响因素

Analysis of influencing factors of vaginal delivery in primiparas

目的收集初产妇分娩相关资料,分析经阴分娩影响因素,为提高经阴分娩率提出举措。方法选取产科收治的初产妇作为研究对象,利用单因素分析法筛选与孕妇经阴分娩有关的因素,将有统计学意义的变量进行多因素Logistic回归分析,得出孕妇经阴分娩的独立影响因素。结果409例初产妇经阴分娩率为58.7%,剖宫产率为41.3%。在孕妇年龄、身高、产前体质量、产前BMI、有无妊娠期高血压、有无妊娠期高血糖、入院时宫颈Bishop评分、宫口开大评分、先露位置评分方面,经阴分娩组与剖宫产组比较,差异有统计学意义(P<0.05)。多因素Logistic回归分析,结果显示合并妊娠期高血糖及孕期增重为经阴分娩的独立危险因素(P<0.05);入院时宫颈Bishop评分为经阴分娩的独立保护因素(P<0.05)。结论孕前适当调整体重,孕期控制体重增加,密切监测孕妇孕期血糖及血压变化,均对提高经阴分娩率具有重要意义。

Objective To collect the data of primipara delivery,analyze the influencing factors of vaginal delivery,and put forward measures to improve the rate of vaginal delivery.Methods The primary parturients admitted to the Obstetrics Department were selected as the research objects,and the factors related to vaginal delivery were screened by univariate analysis,and the variables with statistical significance were analyzed by multivariate Logistic regression to obtain the independent influencing factors of vaginal delivery.Results The rate of vaginal delivery and cesarean section was 58.7% and 41.3% among 409 primipara.There were statistically significant differences in maternal age,height,prenatal body mass,prenatal BMI,gestational hypertension,gestational hyperglycemia,Bishop score after admission,cervical dilatation score and exposure position score between the vaginal delivery group and the cesarean section group(P<0.05).Multivariate Logistic regression analysis showed that gestational hyperglycemia and weight gain during pregnancy were independent risk factors for vaginal delivery(P<0.05).Bishop score at admission was an independent protective factor for vaginal delivery(P<0.05).Conclusion Appropriate weight adjustment before pregnancy,weight gain control during pregnancy,and close monitoring of blood glucose and blood pressure changes during pregnancy are of great significance for improving the rate of vaginal delivery.