“全面二孩”政策实施后再生育人群现状调查分析

Investigation and analysis of the status of re-born population after the implementation of the universal two-child policy

目的探讨'全面二孩'政策开放前后昆明市产妇人口学特征、剖宫产率等变化情况,为政府部门完善生育政策提供依据。方法利用'昆明市妇幼健康信息'系统,对2014-2017年产妇健康档案信息进行数据收集,对再生育人群分娩年龄趋势、文化程度、职业特点、剖宫产率及配偶年龄、职业及文化程度等信息进行分析。结果 '全面二孩'政策实施后两年较实施前两年,昆明市产妇数量增加27. 17%;二胎产妇构成比增加36. 81%;高龄产妇构成比增加39. 13%;高龄二胎产妇构成比增加33. 21%;高龄初产妇构成比减少52. 60%。二胎产妇剖宫产率呈现逐年增加趋势;各胎次产妇分娩平均年龄均呈持续缓慢增长趋势;产妇及其丈夫的不同文化程度和职业组别在各年度间构成比变化均有显著性差异;Logistic回归分析结果,生育二胎的相关影响因素包括产妇及其配偶的职业和文化程度,由职业和文化程度造成的差异正逐步缩小。结论 '全面二孩'政策实施后分娩人数增加,但未达预测水平;再生育人群人口学变化特点与我国社会经济文化发展水平相符;提高高危孕产妇管理及救治能力是'全面二孩'政策实施后孕产妇死亡控制的工作重点;政策实施对初产妇生育年龄和分娩方式带来一定影响。

Objective To analyze the changes of maternal demographic characteristics and cesarean section rate in Kunming before and after the opening of The Universal'Two-Child Policy',and to provide evidence for the government to improve the fertility policy.Methods Using the'Kunming Maternal and Child Health Information'system to collect data on maternal health archives from 2014 to2017,then analyze the information about the age trend,educational level,occupational characteristics,cesarean section rate and spouse age,occupation&educational level of the reborn population and so on.Results Two years after the implementation of The Universal'Two-Child Policy',the number of parturients in kunming increased by 27.17%,The proportion of maternal second birth increased by36.81%.The proportion of elderly parturients increased by 39.13%.The composition ratio of elderly second-born women increased by33.21%.The proportion of elderly first-time mothers decreased by 52.60%.The cesarean section rate of the second-born women showed an increasing trend year by year;the average age of the delivery of the fetuses in each of the fetuses showed a sustained and slow growth trend;There were significant differences in the composition of the maternal and her husband in different educational level and occupation groups.Logistic regression analysis results showed that the relevant factors of second birth included the occupation and education level of the mother and her spouse,and the difference caused by occupation and education level was gradually narrowing.Conclusion the number of births increased after the implementation of The Universal'Two-Child Policy',but it did not reach the predicted level.The demographic change characteristics of the reproducing population are consistent with the level of social,economic and cultural development in China.Improving the management and treatment capacity of high-risk maternal women is the focus of maternal mortality control after the implementation of The Universal'Two-Child Policy';The implementation of the policy has a certain impact on the age and mode of the unipara.