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目的比较剖宫产率及剖宫产手术指征的变化趋势,为促进自然分娩、优化分娩结局提供科学依据。方法对海口市妇幼保健院2010年1月—2014年9月的26 465例产妇资料进行回顾性分析,采用卡方趋势检验比较剖宫产率随时间的变化趋势。结果该研究共纳入产妇26 465例,新生儿27 137例;产妇年龄17~47岁,平均年龄(29.7±4.9)岁。产妇剖宫产率从2010年的37.0%下降到2012年的33.5%,2013年回升到35.5%,2014年再次下降至31.8%;总体来说,5年间剖宫产率呈下降趋势(P<0.01),而顺产率则呈上升趋势(P<0.01)。2010和2011年产妇剖宫产第1位的手术指征为社会学因素,分别占18.2%和17.1%;2012年剖宫产术手术指征构成中,社会因素下降至第3位,占10.8%;2013年下降至第8位,构成比为5.0%;2014年进一步下降至第9位,构成比为3.8%。高龄产妇手术指征由2010、2011年的第9位(分别占5.2%和4.2%)上升至2012年的第6位(构成比为8.9%),2013年继续上升至第4位(构成比为11.1%),2014年上升至第2位(构成比12.8%)。结论自2010年以来,该院剖宫产率总体呈下降趋势,但仍处于较高水平;社会因素对剖宫产率的影响在降低,而高龄产妇对剖宫产率的影响在增加。
Objective To compare the trend of cesarean section rate and cesarean section operation indications and to provide a scientific basis for promoting natural childbirth and optimizing delivery outcomes. Methods A retrospective analysis of 26 465 maternal data from January 2010 to September 2014 in Haikou MCH was conducted. The trend of cesarean section rate with time was compared by chi-square test. Results A total of 26 465 maternal and 27 137 newborns were enrolled in the study. Maternal age ranged from 17 to 47 years with a mean age of 29.7 ± 4.9 years. The rate of cesarean section decreased from 37.0% in 2010 to 33.5% in 2012, and then rose to 35.5% in 2013 and dropped to 31.8% in 2014. Overall, the rate of cesarean section showed a decreasing trend in 5 years (P < 0.01), while the yield of homeostasis increased (P <0.01). The first and second cesarean section indications in 2010 and 2011 were sociological factors, accounting for 18.2% and 17.1% respectively. Among the indications for cesarean section in 2012, the social factor dropped to third place, accounting for 10.8% %; 2013 down to the first 8, the composition ratio of 5.0%; 2014 further down to 9th, the composition ratio of 3.8%. Elderly maternal surgical indications increased from 9th in 2010 and 2011 (5.2% and 4.2% respectively) to 6th in 2012 (8.9%), and continued to rise to 4th place in 2013 (constituent ratio 11.1%), which rose to No. 2 in 2014 (constituting 12.8%). Conclusion Since 2010, the cesarean section rate of the hospital has generally declined, but it is still at a high level. The impact of social factors on the rate of cesarean section is decreasing, while the impact of older mothers on cesarean section rate is increasing.