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目的:分析徐州地区孕产妇分娩方式的变化趋势,探讨剖宫产术的影响因素。方法:回顾性分析2005~2009年在徐州市妇幼保健院接受阴道分娩和剖宫产的孕产妇9 712例。结果:2005~2009年34.75%的产妇为阴道分娩,其中1.15%为阴道助产,阴道助产率明显下降,从2005年的1.93%下降至2009年的0.63%(P<0.01);65.15%为剖宫产,剖宫产率从2005年的60.17%上升至2009年的67.53%(P<0.01);各年剖宫产率呈逐渐上升趋势。剖宫产因素为:胎儿窘迫、胎位异常、及社会因素等,但每年顺位有变化;其中社会因素剖宫产的比率逐渐上升。结论:徐州地区剖宫产率处于较高水平,高剖宫产率受多种因素影响。社会因素中对剖宫产弊端了解不足、住院时未临产、医生的分娩建议不明确,因不孕症通过辅助生殖技术的应用而妊娠等是无指征剖宫产的影响因素。社会因素一定程度上影响着科学合理分娩方式的选择。
Objective: To analyze the changing trend of delivery mode of pregnant women in Xuzhou and to explore the influencing factors of cesarean section. Methods: A retrospective analysis of 9 712 pregnant women receiving vaginal delivery and cesarean section in the MCH from 2005 to 2009 in Xuzhou was conducted. Results: From 2005 to 2009, 34.75% of the mothers were vaginal delivery, of which 1.15% were vaginal delivery and the vaginal delivery rate was significantly decreased from 1.93% in 2005 to 0.63% in 2009 (P <0.01); 65.15% For cesarean section, the rate of cesarean section increased from 60.17% in 2005 to 67.53% in 2009 (P <0.01). Cesarean section rate showed a gradual upward trend in each year. Cesarean section factors: fetal distress, fetal abnormalities, and social factors, but the annual changes in the rank; which social factors, the proportion of cesarean section gradually increased. Conclusion: The rate of cesarean section in Xuzhou is at a high level and the rate of high cesarean section is affected by many factors. Cesarean section of social factors in the inadequate understanding of inadequate hospitalization without labor, the doctor’s advice of labor is not clear, because of infertility through the application of assisted reproductive technology, pregnancy and other indicators of cesarean section is not an influencing factor. Social factors to a certain extent affect the choice of scientific and rational mode of delivery.