入院待产时间对剖宫产分娩的影响研究  

Association between Early Admission in Labor and Cesarean Delivery

作　　者：叶小云[1] 周青[1] 池竟未[1] 卢颖州[2] 何电[3] 

机构地区：[1]温州医科大学附属第一医院病案室,浙江省温州市325000 [2]首都医科大学附属复兴医院产科 [3]首都医科大学公共卫生学院流行病与卫生统计学系

出　　处：《中国全科医学》2014年第34期4090-4092,共3页Chinese General Practice

基　　金：首都医科大学基础-临床科研合作基金(13JL85)

摘　　要：目的探讨入院待产时间对剖宫产分娩的影响,为进行入院待产时间的管理和降低剖宫产率提供依据。方法选取2004年1月—2013年12月在本院产科住院分娩的产妇为研究对象,采用病例对照的研究方法,以剖宫产分娩的产妇为病例组,阴道分娩为对照组,比较两组人群入院待产时间是否存在差异。同时采用多因素分析调整剖宫产指征、产妇年龄、婴儿性别等因素对两者关联的影响。结果阴道分娩组有90.0%(1 243/1 381)的产妇入院待产时间≤3 d,高于剖宫产组的73.2%(1 447/1 978),差异有统计学意义(Z=170.064,P<0.01)。Logistic回归分析显示,年龄越大〔>34岁比<20岁,OR=2.75,95%CI(1.45,5.22)〕、产前有剖宫产指征〔OR=6.00,95%CI(5.09,7.09)〕、入院待产时间越长〔>7 d比0 d,OR=4.14,95%CI(2.86,5.97)〕,产妇剖宫产分娩的可能性也增加(P<0.05)。结论产妇分娩年龄越大、分娩前有剖宫产指征、入院待产时间越长,越有可能选择剖宫产分娩。Objective To explore the association between early admission in labor and cesarean delivery so as to provide references for the management of the early admission in labor and the drop of cesarean delivery rate. Methods In the study,puerperal women were selected in this hospital from Jan. 2004 to Dec. 2013. A case-control study was used to compare the difference of early admission in labor between the two delivery methods： cesarean delivery（ case group） and vaginal birth（ control group）. Multi-factor analysis was used for the influences of adjusting cesarean section indicators,maternal age,infant gender and other factors over the association. Results The ratio of early admission in labor,which was less than 3 days,accounted for90. 0%（ 1 243 /1 381） in vaginal delivery group,which was higher than 73. 2%（ 1 447 /1 978） in cesarean group,with significant difference（ Z = 170. 064,P〈0. 01）. The logistic regression analysis showed that pregnant women,with old age〔 〉34 years old vs. 〈20 years old,OR = 2. 75,95% CI（ 1. 45,5. 22） 〕,having cesarean section indicators 〔（ OR = 6. 00,95% CI（ 5. 09,7. 09） 〕,longer early admission in labor〔 〉7 days vs. 0,OR = 4. 14,95% CI（ 2. 86,5. 97） 〕,were more likely to choose cesarean delivery（ P〈0. 05）. Conclusion Pregnant women,with old age,having cesarean section indicators and longer early admission in labor,were more likely to choose cesarean delivery.

关 键 词：剖宫产术 入院待产时间 病例对照研究 

分 类 号：R714.3[医药卫生—妇产科学]