社会因素剖宫产率及其影响因素.DOC

芜湖及周边地区妇女产前保健服务与分娩方式的关联研究 徐艳1, 2 郝加虎1，黄朝辉1，宋玉梅1，庞培1，李诺1，张婉婉1 【摘要】 目的 探讨芜湖及周边地区妇女剖宫产流行病学分布特征及其与孕产妇保健服务的关联性。方法 选取安徽省巢湖和芜湖市2009年有过分娩史的产妇共计490例，采用自填式问卷的方法收集孕产妇的基本信息。调查内容包括人口统计学变量、孕产妇保健服务情况及本次实际采取的分娩方式等。采用多因素logistic回归模型进行分析。结果 490例孕产妇中，139名（28.4%）的分娩方式为自然分娩，180名（36.7%）的分娩方式为医学指征剖宫产，171名（34.9%）的分娩方式为社会因素剖宫产。多因素logistic回归显示，产检次数大于8次（OR=2.386, 95% CI =1.124-5.064）、入院时具有临产先兆（OR=0.091, 95% CI =0.031-0.269）、具有流产史（OR=1.867, 95% CI =1.000-3.505）是影响医学指征剖宫产的因素。而第一次产检时孕周大于12周（OR=0.447, 95% CI =0.230-0.868）、产检医院为社区/乡镇医院（OR=0.406, 95% CI =0.200-0.825）、产检有异常（OR=0.285, 95% CI =0.108-0.746）、入院时有临产先兆（OR=0.053, 95% CI =0.018-0.157）与社会因素剖宫产存在统计学关联。结论 孕产妇接受产前保健服务情况与分娩方式的选择存在一定的关联性，孕产妇保健服务应引起妇幼保健工作人员的重视。 【关键词】孕产妇；剖宫产术；危险因素 Association of Prenatal Care with Delivery Mode among Pregnant women in Southern Anhui. XU Yan, HAO Jia-hu, HUANG Zhao-hui, et al. （Department of Maternal, Child Adolescent Health, School of Public Health, Anhui Medical University, Hefei, 230032, China） 【Abstract】 Objective To examine the delivery mode and its association with health care services in southern Anhui. Methods The data that included social demographic characteristics, health care services and delivery mode were collected by self-administrated questionnaire from 490 cases women who had delivery history in 2009 year from Chaohu and Wuhu city of Anhui province, . to analysis using Multinomial logistic regression by SPSS software (version 10.0). Results There were 139 of 490 cases (28.4%) take spontaneous delivery to terminate pregnancy; 180 of 490 cases(36.7%) take uterine-incision delivery because of medical indication; and 171 of 490 cases (34.9%) take uterine-incision delivery because of social factor. The logistic regression analyses showed that, antenatal examination time ≥8 （OR=2.386, 95% CI =1.124-5.064）, threatened in labor（OR=0.091, 95% CI =0.031-0.269）, had abortion history （OR=1.867, 95% CI =1.000-3.505）were associated with having an emergency caesarean section. Having an elective caesarea