2016年-2019年北京某三甲医院高龄孕产妇剖宫产率变化趋势及影响因素  

Changing Trend and Influencing Factors of Cesarean Section Rate of Advanced Maternal Age in a Tertiary Hospital in Beijing from 2016 to 2019

作　　者：邢宇[1] 王欣[1] Xing Yu;Wang Xin(Obstetrics Department,Beijing Obstetrics and Gynecology Hospital,Capital Medical University,Beijing 100026,China;不详)

机构地区：[1]首都医科大学附属北京妇产医院产科,北京市100026

出　　处：《中国病案》2020年第6期49-52,共4页Chinese Medical Record

摘　　要：目的探讨北京某三甲妇产专科医院近年来高龄孕产妇剖宫产率变化趋势及其影响因素。方法选取2016年1月-2019年6月北京市某三级甲等妇产专科医院15 091例高龄孕产妇,以剖宫产分娩的7597例为剖宫产组,自然分娩的7494例为自然分娩组,剖宫产手术指征以第一指征为主,回顾性分析剖宫产率变化趋势;采用Logistic多元回归分析方法分析高龄孕产妇剖宫产影响因素。结果 2016年1月-2019年6月高龄孕产妇的剖宫产率呈上升趋势;剖宫产的前5位指征依次为:剖宫产再孕(43.34%~52.09%)、胎儿窘迫(5.57%~9.97%)、胎位异常(6.66%~8.08%)、高龄(4.82%~6.92%)、双胎(5.10%~5.63%);Logistic多元回归分析结果显示,剖宫产再孕(OR:145.565,95%CI:121.822~173.935)、胎位异常(OR:57.843,95%CI:37.915~88.246)、双胎(OR:19.748,95%CI:13.559~28.762)、年龄(OR:1.225,95%CI:1.200~1.250)、分娩孕周(OR:0.844,95%CI:0.823~0.865)、分娩次数(OR:0.211,95%CI:0.191~0.232)是高龄孕产妇剖宫产的影响因素。结论对于高龄孕产妇,应综合评价后决定分娩方式,密切观察并及时处理并发症,适时终止妊娠,鼓励进行阴道试产,但可以适当放宽剖宫产的指征,积极处理,以免产生不良后果。Objective To explore the changing trend of cesarean section rate of advanced maternal age and its influencing factors in a tertiary obstetrics and gynecology hospital in Beijing in recent years.Methods From January 2016 to June 2019,15091 advanced maternal age were selected from a tertiary obstetrics and gynecology hospital in Beijing.7597 cases of cesarean delivery were taken as cesarean section group and 7494 cases of natural delivery were taken as natural delivery group.The indications for cesarean section were mainly the first indication.The changing trend of cesarean section rate was analyzed retrospectively.Logistic multiple regression analysis was used to analyze the influencing factors of cesarean section for advanced maternal age.Results The cesarean section rate of advanced maternal age showed an upward trend from 2016 to the first half of 2019.The top five indications for cesarean section are:re-pregnancy after cesarean section(43.34%~52.09%),fetal distress(5.57%~9.97%),malposition of fetus(6.66%~8.08%),advanced maternal age(4.82%~6.92%),twin pregnancy(5.10%~5.63%).Logistic multiple regression analysis showed that re-pregnancy after cesarean section(OR:145.565,95%CI:121.822~173.935),malpositionof fetus(OR:57.843,95%CI:37.915~88.246),twin pregnancy(OR:19.748,95%CI:13.559~28.762),age(OR:1.225,95%CI:1.200~1.250),gestational week of delivery(OR:0.844,95%CI:0.823~0.865)and delivery times(OR:0.211,95%CI:0.191~0.232)are the influencing factors of cesarean section for advanced maternal age.Conclusion For advanced maternal age,we should make comprehensive evaluation and determine the mode of delivery,closely observe and treat complications in time,terminate pregnancy in time,encourage their vaginal trial,but appropriately relax the indications of cesarean section,actively deal with it to avoid adverse consequences.

关 键 词：高龄孕产妇 剖宫产率 剖宫产再孕 

分 类 号：R714.8[医药卫生—妇产科学]