北京地区剖宫产率变化及指征分析

发布时间：2018-08-03 19:46

【摘要】：目的研究北京地区近30年剖宫产率变化情况及剖宫产指征分析。方法选择2013年6月~2014年7月在北京城区6所医院妇科/妇检门诊要求常规体检的20~65岁已生育女性。采用自制北京地区产后女性生殖健康状况调查表对研究女性进行面对面调查,调查内容包括研究对象的一般情况、分娩情况及剖宫产指征。结果 2649例生育女性,按照末次妊娠的分娩方式,分为阴道分娩组1521例,剖宫产组女性1128例。调查人群总剖宫产率为42.6%,剖宫产率自1999年后进行性大幅上升,2009~2013年间剖宫产率达到57%。初次剖宫产的主要指征为社会因素,占总剖宫产率的26.33%,其次为难产,占总剖宫产率的12.5%。剖宫产和阴道分娩比率与受教育程度密切相关,受教育水平大专及大学组剖宫产比率最高(χ~2=24.585,P=0.000)。社会因素剖宫产比率在2004~2008年间达到高峰(36.8%),2009年后出现下降。高龄初产的比率逐年上升。结论北京地区剖宫产率逐年升高(截至2013年底),1999年后剖宫产率增长明显,剖宫产率升高的主要原因是社会因素导致的无指征剖宫产率增多。剖宫产和阴道分娩比率与受教育程度及家庭收入显著相关。无指征剖宫产比率2009年后出现下降。高龄初产的比率逐年上升。过期妊娠为指征的剖宫产比率逐年下降。
[Abstract]:Objective to study the changes of cesarean section rate and the indications of cesarean section in Beijing. Methods from June 2013 to July 2014, women aged 20 to 65 were selected from gynecological / female outpatient clinics of 6 hospitals in Beijing urban area to require routine physical examination. A self-made questionnaire on the reproductive health of postpartum women in Beijing was used to carry out a face to face investigation on the women in the study. The contents of the investigation included the general situation of the subjects, the situation of delivery and the indications of cesarean section. Results 2649 women were divided into vaginal delivery group (n = 1521) and cesarean section group (n = 1128). The total rate of cesarean section was 42.6%, and the rate of cesarean section increased significantly since 1999. The rate of cesarean section reached 57.7% between 2009 and 2013. The main indication of the first cesarean section was social factor, which accounted for 26.33% of the total cesarean section rate, followed by dystocia rate and 12.5% of the total cesarean section rate. The ratio of cesarean section and vaginal delivery was closely related to the level of education, and the rate of cesarean section in college and university group was the highest (蠂 ~ 2 / 24. 585p ~ (0.000). The social factor cesarean section rate peaked in 2004 and 2008 (36.8%) and declined after 2009. The rate of first births at old age increases year by year. Conclusion the rate of cesarean section in Beijing is increasing year by year (up to the end of 2013). After 1999, the rate of cesarean section has increased obviously. The main reason for the increase of cesarean section rate is the increase of unindicated cesarean section rate caused by social factors. The rates of cesarean section and vaginal delivery were significantly correlated with education and family income. The rate of cesarean section without indication declined after 2009. The rate of first births at old age increases year by year. The rate of cesarean section with overdue pregnancy as indication decreased year by year.
【作者单位】：首都医科大学附属北京妇产医院;首都医科大学北京神经外科研究所流行病学室;
【分类号】：R719.8

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