北京、上海、成都三市剖宫产的影响因素研究

程怡民; 袁伟; 菜卫东; 张文敏; 王铁燕; 王燕; 吴世仲; 周利峰; 罗琳; 高尔生

Abstract

程怡民,袁伟,菜卫东,张文敏,王铁燕,王燕,吴世仲,周利峰,罗琳,高尔生.北京、上海、成都三市剖宫产的影响因素研究[J].Chinese journal of Epidemiology,2003,24(10):893-896

北京、上海、成都三市剖宫产的影响因素研究

Study on the occurrence of cesarean section (CS) and factors related to CS in China

Received:January 20, 2003

DOI：

KeyWord: 剖宫产影响因素人口学特征

English Key Word: Cesarean section Risk factors Demographic characteristic

FundProject:

Author Name	Affiliation
CHENG Yi-min	National Research Institute for Family Planning, Beijing 100081, China
YUAN Wei	上海市计划生育科学技术研究所
CAI Wei-dong	四川省计划生育科学技术研究所
ZHANG Wen-m in	北京市宣武医院
WANG Tie-yan	北京市海淀妇产医院
WANG Yan	中日友好医院
WU Shi-zhong	四川省计划生育科学技术研究所
ZHOU Li-feng	上海市计划生育科学技术研究所
LUO Lin	四川省计划生育科学技术研究所
GAO Er-sheng	上海市计划生育科学技术研究所

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Abstract:

目的了解剖宫产的发生率及与较高剖宫产率有关的影响因素。方法采用面对面问卷调查;剖宫产者为“病例组”,正常产者为“对照组”,进行病例对照研究。结果在14071名初产妇中,剖宫产者有6421人(病例组),剖宫产发生率为45.6%;正常分娩有7650人(对照组),占54.4%;与正常分娩组相比,剖宫产组有以下5个比例较高和8种影响因素较多,两组间差异均有非常显著性(P均<0.01)。5个比例较高的因素分别为文化程度高(78.9%∶69.5%)、白领阶层多(38.0%∶32.3%)、城市户口多(79.1%∶70.6%)、月收入较高的多(≥500元,81.0%∶70.6%)以及年龄大的多(≥25岁,73.3%∶63.0%)。此外,8种因素均较多的为:婴儿体重超4000g(8.3%∶2.9%)、男性胎儿(53.9%∶51.4%)、母亲体重指数>24(8.8%∶4.8%)、头盆不称(21.1%∶0.9%)、胎儿宫内窘迫(20.3%∶6.7%)、产力异常(4.2%∶2.7%)、滞产(2.9%∶1.0%)以及前置胎盘(1.4%∶0.4%)。特别强调的是,在剖宫产组,初产妇年龄>24岁的比例高达70%以上,头盆不称和胎儿宫内窘迫都高达20%以上。两组间差异有非常显著性。结论目前中国剖宫产率相当高,较高的剖宫产率不但与生理医学因

English Abstract:

Objective　To find out the occurrence of cesarean sectio n (CS)and to probe the factors associa ted with CS.Methods　Women with CS as“ case group” and women without CS as“ control group”were chosen in a case-contro l study.Results Amo ng 14 071 childbirth women, 6 421 had CS (case g roup)with the occur rence rate of 45.6 % and 7 650 (54.4%)had normal delivery (control group).In comparison with the control group, the CS g roup had following several hig her rates [ with sig nificant differences between case g roup and control g roup (P <0.01)] :well-educated (78.9 % vs 69.5 %), white collar jobs (38.0 % vs 32.3 %), urban residents (79.1% vs 70.6 %), high monthly income (≥500 Yuan)(81.0% vs 70.6 %), of older age (≥25 years)(73.3% vs 63.0 %), heavier baby weight (> 4 000 g ram)(8.3 % vs 2.9 %), male babies (53.9 % vs 51.4%), BMI of mother (>24)(8.8 % vs 4.8 %), cephalopelvic dispropor tion (21.1 % vs 0.9%), intrauterine asphysia (20.3 % vs 6.7 %),abnormality of force of labor (4.2 % vs 2.7 %), prolonged labor (2.9 % vs 1.0%)and placenta previa(1.4% v s 0.4%).Our study also indicated that the hig her the educational level was, the higher the rate of CS appeared ;and the older the pregnant women was, the hig her the rate of CS was.In CS g roup, ov er 70 % primipara were over 24 years, and over 20% primipara had cephalopelvic dispropor tio n and over 20 % had intrauterine asphy sia in CS group.Conclusions　At present, the occurrence rate of cesarean section was rather high (45.6 %)in China.The hig h rate of CS was more likely to associate not only with abno rmal phy siological medical factor s (eg.cephalopelvic dispro portion, intrauterine asphysia, abnormality of force of labor, and prolonged labour, etc.), but also with some demog raphic factors as education, occupation, income and age, etc.I t is necessary to take measures to reduce the unnecessary CS in China.

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