| 王菊霞,孙会芹,黄锟,郑贤芳,陶芳标.基于Robson分类系统的医院剖宫产率变化及其产妇特征分析[J].中华流行病学杂志,2017,38(7):963-967 |
| 基于Robson分类系统的医院剖宫产率变化及其产妇特征分析 |
| Trend of caesarean section rate and puerpera characteristics:based on Robson classification |
| 收稿日期:2016-12-12 出版日期:2017-07-15 |
| DOI：10.3760/cma.j.issn.0254-6450.2017.07.023 |
| 中文关键词: 剖宫产率 产妇特征 Robson分类 |
| 英文关键词: Caesarean section Maternal characteristics Robson classification |
| 基金项目:国家自然科学基金（81373012） |
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| 中文摘要: |
| 目的 分析医院剖宫产率变化和收治产妇的人群特征，为妇幼卫生政策和临床实践提供参考。方法 选择安徽医科大学附属巢湖医院2010年10月1日至2016年9月30日住院分娩的12 041名产妇作为研究对象，应用Robson分类系统分析各组产妇的剖宫产率变化，以及其与二孩政策、出生婴儿性别比之间的关系。结果 近6年医院总剖宫产率从66.9%降低至44.2%，其中单胎头位足月妊娠初产妇（R1+R2）降低至32.1%，经产妇无子宫疤痕者（R3+R4）降低至14.2%，早产者降低至22.9%，组内差异有统计学意义（P<0.01）；自然分娩组（R1、R3）、疤痕子宫再妊娠组（R5）、双胎妊娠组（R8）产妇构成比呈上升趋势，组内差异有统计学意义（P<0.01）；医院年度总出生婴儿男女性别比是110~128：100，R1组女婴多且比例稳定，R10组（早产）和经产妇组（R4、R5）男婴比例高，但R4组2015、2016年度男婴下降明显。结论 单胎头位初产妇、无子宫疤痕经产妇和早产者是医院降低剖宫产率的重点监测人群，疤痕子宫再妊娠、臀位、双胎妊娠者的剖宫产率及构成比变化存在不确定性，应用Robson分类法可提高剖宫产率监测数据的可比性。 |
| 英文摘要: |
| Objective To analyze the trend in caesarean section rate and puerpera characteristics in hospital, and provide valuable information for maternal and child health policy making and clinical practice. Methods A total of 12 041 women who delivered in the affiliated Chaohu Hospital of Anhui Medical University from October 1, 2010 to September 30, 2016 were selected. Based on Robson classification system, changes in the rate of caesarean delivery as well as its relationship with two-child policy and infant sex ratio were analyzed. Results The overall caesarean section rate gradually decreased from 66.9% to 44.2% during the past six years. Respectively, the caesarean section rate in primiparae with singleton term babies decreased to 32.1% and the rate in multiparas without uterine scar decreased to 14.2%, and the rate in premature delivery decreased to 22.9%, the differences were significant (P<0.01). The proportion of vaginal delivery (R1, R3), multiparas with uterine scar (R5) and twins pregnancy (R8) increased. the differences were significant (P<0.01). The annual overall newly-born sex ratio ranged from 110:100 to 128:100. In group R1, more babies were girls, the proportion was stable, more women with premature delivery and multiparas had boy babies, but the boy babies by multiparas without uterine scar obviously decreased in the last 2 years. Conclusions Primiparae with singleton head birth, multipara without uterine scar and women with premature deliveries are the key population in the effort of reduction of caesarean section rate. The caesarean section rate and proportion were unstable in multiparas with uterine scar, breech deliveries and twin deliveries. The application of Robson classification system can improve the comparability of the surveillance data. |
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