高龄二胎孕妇分娩方式选择影响因素分析  

Analysis on the influencing factors of delivery mode choice in the second-born pregnant women with advanced reproductive age

作　　者：王永淑[1] 杜敏霞[2] 薛清杰[1] WANG Yong-shu;DU Min-xia;XUE Qing-jie(Department of Obstetrics and Gynecology,the Third Affiliated Hospital of Xinxiang Medical University,Xinxiang 453003,Henan Province,China;Nursing College of Xinxiang Medical University,Xinxiang 453003,Henan Province,China)

机构地区：[1]新乡医学院第三附属医院妇产科,河南新乡453003 [2]新乡医学院护理学院,河南新乡453003

出　　处：《新乡医学院学报》2018年第12期1086-1088,1093,共4页Journal of Xinxiang Medical University

基　　金：河南省教育科学"十三五"规划课题(编号:2016-JKGHB-0231)

摘　　要：目的探讨高龄二胎孕妇分娩方式选择的影响因素。方法选择2015年2月至2018年2月于新乡医学院第三附属医院分娩的485例高龄二胎孕妇为研究对象。通过自制调查问卷采集孕妇分娩方式意愿、首胎分娩方式、年龄、孕前体质量指数(BMI)、文化水平、户籍、职业、分娩认知评分等信息,并记录孕妇最终分娩方式及不良妊娠结局发生情况。对高龄二胎孕妇分娩方式选择的影响因素进行单因素和多因素logistic回归分析。结果 485例孕妇预期选择阴道分娩者309例(63. 71%),选择剖宫产者176例(36. 29%);预期选择阴道分娩的309例孕妇中,最终实际阴道分娩216例(69. 90%),剖宫产93例(30. 10%);预期选择剖宫产的176例孕妇中,最终实际阴道分娩84例(47. 73%),剖宫产92例(52. 27%)。309例预期选择阴道分娩孕妇的不良妊娠结局发生率为5. 50%(17/309),176例预期选择剖宫产孕妇的不良妊娠结局发生率为10. 79%(19/176),预期选择剖宫产孕妇不良妊娠结局发生率高于预期选择阴道分娩孕妇(χ~2=4. 573,P <0. 05)。首胎分娩方式、孕妇年龄、孕前BMI、分娩认知评分与高龄二胎孕妇分娩方式选择有关(P <0. 05)。孕妇文化水平、户籍及职业与高龄二胎孕妇分娩方式选择无关(P> 0. 05)。多因素logistic回归分析显示,首胎分娩方式、孕妇年龄、孕前BMI、分娩认知评分是高龄二胎孕妇分娩方式选择的影响因素(P <0. 05)。结论影响高龄二胎孕妇选择分娩方式的因素较多,首胎分娩方式、年龄、孕前BMI及分娩认知评分是高龄二胎孕妇选择分娩方式的重要影响因素。针对相关影响因素制定相应的干预措施,有利于高龄二胎孕妇合理选择分娩方式。Objective To investigate the influencing factors of the choice of delivery mode in the second-born pregnant women with advanced reproductive age.Methods A total of 485 advanced reproductive age pregnant women with the second-born in the Third Affiliated Hospital of Xinxiang Medical University from February 2015 to February 2018 were selected as the study subjects.The information including pregnant women′s willingness to delivery mode,first delivery mode,age,body mass index(BMI)before pregnancy,educational level,household registration,occupation and delivery cognition score were collected by self-made questionnaires.The final delivery mode and adverse pregnancy outcomes of the pregnant women were also recorded.The influencing factors of delivery mode choice in the second-born pregnant women with advanced reproductive age were analyzed by univariate and multivariate logistic regression analysis.Results Among the 485 pregnant women,309(63.71%)pregnant women expected to choose the vaginal delivery,and 176(36.29%)pregnant women expected to choose the cesarean section.Among the 309 pregnant women who expected to choose vaginal delivery,216(69.90%)pregnant women performed with vaginal delivery,and 93(30.10%)pregnant women performed with cesarean section finally.Among the 176 pregnant women who expected to choose cesarean section,84(47.73%)pregnant women performed with vaginal delivery,and 92(52.27%)pregnant women performed with cesarean section finally.The incidence of adverse pregnancy outcomes was 5.50%(17/309)in 309 expectant vaginal delivery women,and it was 10.79%(19/176)in 176 expectant cesarean delivery women.The incidence of adverse pregnancy outcomes in women who expected to choose cesarean section was higher than that in women who expected to choose vaginal delivery(χ^2=4.573,P<0.05).The first delivery mode,the age of pregnant women,BMI before pregnancy and delivery cognition score were related to the delivery mode choice in the second-born pregnant women with advanced reproductive age(P<0.05).The education

关 键 词：高龄孕妇 二胎 分娩方式 影响因素 

分 类 号：R714[医药卫生—妇产科学]