剖宫产产妇产前剖宫产偏好及原因分析  

Analysis of reasons and preference for caesarean section among parturient underwent caesarean section

作　　者：吴静[1] 张红卫[2] 郭利 

机构地区：[1]国家开放大学农林医药教学部,北京100039 [2]首都医科大学附属北京妇产医院门诊部,北京100026 [3]首都医科大学附属北京妇产医院围产医学部,北京100026

出　　处：《中华疾病控制杂志》2016年第8期839-842,共4页Chinese Journal of Disease Control & Prevention

基　　金：首都医科大学附属北京妇产医院中青年学科骨干培养专项课题(fcyy201413)

摘　　要：目的了解剖宫产产妇产前剖宫产偏好率、偏好原因、分娩并发症知识水平及影响因素。方法研究者于2014年4~6月在北京某三甲妇产专科医院调查门诊产检的孕妇,采用自行设计的问卷收集资料。调查一般人口学信息、孕产史、分娩方式偏好原因及分娩并发症知识等。结果共调查192名剖宫产产妇,其中70人产前偏好剖宫产。偏好剖宫产的主要理由为减少胎儿宫内窒息的危险,偏好阴道产的主要理由为阴道产是自然过程、阴道产后恢复更快、阴道产婴儿更健康。多因素结果显示,在所有孕妇中孕次〉1次者（ORadjusted=2.8,95%CI：1.5~5.3）、判断要选用何种分娩方式时只选一种信息源者（ORadjusted=2.5,95%CI：1.0~5.9）、认为医生无权决定自己的分娩方式者（ORadjusted=2.2,95%CI：1.0~4.8）报告更偏好剖宫产。在初产妇中高龄孕妇（ORadjusted=3.4,95%CI：1.5~7.7）、认为医生无权决定自己的分娩方式者（ORadjusted=2.1,95%CI：1.1~6.0）更偏好剖宫产。结论本研究中调查对象剖宫产偏好率高达36.5%,将来有必要针对产前偏好剖宫产者进行干预以降低实际剖宫产率。Objective To understand the preference rate and reasons of caesarean section,and analyse delivery complication knowledge level and influencing factors among parturient underwent caesarean section. Methods A crosssectional study was conducted among women who actually had caesarean section. Data were collected with a self-designed questionnaire in a maternity hospital from April to June,2014. Socio-demographic information,history of gestation and childbearing,reasons of preference for caesarean and delivery complication knowledge investigation results were obtained.Results A total of 192 women were included,and 70 of them preferred caesarean section in the third trimester. The main reason of caesarean preference was to reduce the risk of fetal intrauterine asphyxia. The main reasons of preference for vaginal delivery were natural process,faster recovery,and healthier baby. In multivariate analysis,the following factors were found to be strongly associated with caesarean section preference： gravidity 〉1 time（ ORadjusted= 2. 8,95% CI： 1. 5-5. 3）,having only one information source on preference for delivery route（ ORadjusted= 2. 5,95% CI： 1. 0-5. 9）,denying doctor＇s right to decide delivery mode（ ORadjusted= 2. 2,95% CI： 1. 0-4. 8）. Those women who were older than 35 years（ ORadjusted= 3. 4,95% CI： 1. 5-7. 7） and who thought that doctors have no right to decide the delivery mode for their patients（ ORadjusted= 2. 1,95% CI： 1. 1-6. 0） had significantly higher odds of preferring caesarean section among primiparous women. Conclusions The rate of preference for caesarean section is high（ 36. 5%）. We should take reasonable steps to reduce the actual caesarean rate among women who preferred caesarean section.

关 键 词：剖宫产术 问卷调查 流行病学方法 

分 类 号：R714[医药卫生—妇产科学] R181.2[医药卫生—临床医学]