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重庆市2010-2020年剖宫产率现况及其影响因素分析
Rate of cesarean section and its influencing factors in Chongqing during 2010 and 2020
- 第三军医大学学报 2021年43卷第22期 页码：2495-封3
- 作者机构：
1.1400013 重庆，重庆市妇幼保健院群体保健工作办公室
2.401147 重庆，重庆市卫生健康委员会妇幼健康服务处
- 作者简介：
[周晓军，E-mail: 1186440689@qq.com ZHOU Xiaojun, E-mail: 1186440689@qq.com
- 基金信息：重庆市妇幼保健科研培育专项项目(2020FY202)
DOI：10.16016/j.1000-5404.202105151
中图分类号： R195.1;R719.8收稿：2020-05-27，
修回：2020-06-22，
纸质出版：2021-11-30
- 稿件说明：
移动端阅览
曹奕, 杨相玲, 王正琳, 等. 重庆市2010-2020年剖宫产率现况及其影响因素分析[J]. 第三军医大学学报, 2021,43(22):2495-封3.
Yi CAO, Xiangling YANG, Zhenglin WANG, et al. Rate of cesarean section and its influencing factors in Chongqing during 2010 and 2020[J]. Journal of Third Military Medical University, 2021, 43(22): 2495-封3.
曹奕, 杨相玲, 王正琳, 等. 重庆市2010-2020年剖宫产率现况及其影响因素分析[J]. 第三军医大学学报, 2021,43(22):2495-封3. DOI： 10.16016/j.1000-5404.202105151.
Yi CAO, Xiangling YANG, Zhenglin WANG, et al. Rate of cesarean section and its influencing factors in Chongqing during 2010 and 2020[J]. Journal of Third Military Medical University, 2021, 43(22): 2495-封3. DOI： 10.16016/j.1000-5404.202105151.
摘要
目的
2
分析重庆市2010-2020年剖宫产率现状及其影响因素。
方法
2
采用全面调查的方法，利用2010-2020年《重庆市产科质量调查表》以及出生医学证明数据，以全市提供助产服务的医疗卫生机构为研究对象，进行产妇分娩方式选择情况及其影响因素的现况调查。
结果
2
2020年全市剖宫产率为47.59%，较2019年小幅上升0.15%；首次剖宫产率43.30%，较2019年上升2.29%；非医学指征剖宫产比例为13.20%，较2019年上升19.03%。全市35岁及以上产妇剖宫产率65.85%，远高于18岁以下产妇剖宫产率(25.91%)及18~34岁产妇剖宫产率(45.61%)。全市民营医疗机构剖宫产率为51.83%，高于公立一级医疗机构(31.69%)、二级医疗机构(46.11%)、三级医疗机构(50.50%)以及厂矿医疗机构(44.75%)剖宫产率。2020年，全市有医学指征的剖宫产中，因瘢痕子宫剖宫产的比例最高(45.57%)，其次为高龄产妇(9.73%)、胎儿窘迫(8.78%)、妊娠巨大儿(6.67%)、胎位异常(6.43%)。
结论
2
瘢痕子宫、高龄产妇(年龄≥35岁)、妊娠期严重合并症和并发症、妊娠巨大儿、胎儿窘迫等因素均在剖宫产指征中占有较大比例，严重影响全市剖宫产率的控制。民营机构剖宫产率、首次分娩剖宫产率以及非医学指征剖宫产比例均远高于其他类别助产机构。
Abstract
Objective
2
To analyze the rate of cesarean section and its influencing factors in Chongqing from 2010 to 2020.
Methods
2
A comprehensive survey was adopted based on the Chongqing Obstetrics Quality Questionnaire and the data of birth medical certificate with medical and health institutions which providing midwifery services as the research objects to investigate the current situation of maternal delivery mode selection in the period.
Results
2
In 2020
the cesarean section rate of the whole city was 47.59%
with a slight increase of 0.15% compared with that in 2019. The cesarean section rate of first delivery was 43.30%
with 2.29% higher than that in 2019. The proportion of cesarean section without medical indications was 13.20%
which was 19.03% higher than that in 2019. The cesarean section rate was 65.85% for women over 35 years old
which was much higher than that of women under 18 years old (25.91%) and women between 18 and 34 years old (45.61%). The cesarean section rate of private institutions was 51.83%
higher than that of primary institutions (31.69%)
secondary institutions (46.11%)
tertiary institutions (50.50%) and medical institutions in factories (44.75%). In 2020
the proportion of cesarean section with scarred uterus was the highest (45.57%)
followed by elder women (9.73%)
fetal distress (8.78%)
pregnancy macrosomia (6.67%) and abnormal fetal position (6.43%).
Conclusion
2
Scar uterus
elderly women (age ≥35 years)
severe complications during pregnancy
macrosomia
fetal distress occupy a large proportion in the indications of cesarean section
which seriously affects the decline of the cesarean section rate. The cesarean section rate
cesarean section rate of first delivery and proportion of cesarean section without medical indications are far higher in private institutions than those of other types of midwifery institutions.
关键词
Keywords
references
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