湖南省自然分娩健康促进干预对婴儿母亲分娩方式选择影响

发布时间：2019-02-28 20:50

【摘要】：目的了解湖南省实施自然分娩健康促进干预后婴儿母亲分娩意愿、方式等结局的变化,为进一步完善促进自然分娩的干预措施提供依据。方法本研究为干预前后自身对照研究,分别于2012年7—8月和2015年7—8月,采用两阶段分层整群随机抽样方法,在湖南省6所医院对603名和588名分娩的妇女进行问卷调查。结果基线(干预前)共调查婴儿母亲603人,分娩意愿为自然分娩的共396人(65.67%),剖宫产207人(34.33%);终末(干预后)调查中婴儿母亲588人,自愿选择自然分娩的共426人(74.30%),剖宫产147人(25.70%);干预前后比较差异有统计学意义(χ~2=10.383,P=0.001)。三级医院中,县级医院干预后婴儿母亲自己希望自然分娩的比例提高明显(χ~2=13.325,P0.001)。实施干预前后婴儿母亲分娩意愿为剖宫产的最主要原因分别为产前检查发现异常情况(39.30%)和以前有剖宫产史(44.10%)。干预后选择自然分娩的比例明显提高(χ~2=6.098,P=0.014)。结论湖南省自然分娩健康促进干预对婴儿母亲分娩意愿选择具有影响,干预后自愿选择自然分娩的比例增加,有剖宫产意愿的比例降低,使待产的婴儿母亲增加了自然分娩的信心,减轻临产和分娩的恐惧感,且对医生和医院更加信任。
[Abstract]:Objective to investigate the changes of maternal delivery intention and mode after natural delivery health promotion intervention in Hunan Province, so as to provide evidence for further improvement of intervention measures to promote natural delivery. Methods the study was a self-control study before and after intervention. 603 women and 588 women were surveyed in 6 hospitals of Hunan Province by two-stage stratified cluster random sampling in July-August 2012 and July-August 2015 respectively. Results A total of 603 mothers were surveyed at baseline (before intervention). 396 (65.67%) mothers had spontaneous delivery and 207 (34.33%) had cesarean section. Among the 588 mothers, 426 (74.30%) and 147 (25.70%) were voluntarily chosen for natural labor and cesarean section, respectively (蠂 ~ 2, 10.383, P < 0.001), and there were significant differences before and after intervention (蠂 ~ 2, 10.383, P < 0.001). In tertiary hospitals, the proportion of mothers who wanted to give birth naturally after intervention in county hospitals was significantly increased (蠂 ~ 2, 13.325, P 0.001). The main causes of cesarean delivery were abnormal prenatal examination (39.30%) and previous cesarean section (44.10%). The proportion of natural delivery was significantly increased after intervention (蠂 ~ 2 / 6.098, P = 0.014). Conclusion the health promotion intervention of natural delivery in Hunan province has an effect on the choice of mothers' willingness to give birth, and the proportion of voluntary choice of natural delivery after intervention increases, while the proportion of cesarean section will decrease. Increased confidence in natural childbirth, reduced fear of childbirth and increased trust in doctors and hospitals.
【作者单位】：北京大学公共卫生学院社会医学与健康教育系;
【基金】：联合国人口基金[CHN7U204]
【分类号】：R714

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