基于改良版Robson分级系统的不同生育政策下剖宫产率变化研究  

Study on cesarean section rate change under different fertility policies periods based on modified Robson classification system

作　　者：李晨[1,2] 宋贺 钮慧远 曾雯琼[2] 孙丽洲 Li Chen;Song He;Niu Huiyuan;Zeng Wenqiong;Sun Lizhou(Department of Obstetrics,The First Affiliated Hospital of Nanjing Medical University,Nanjing Jiangsu 210029;Department of Obstetrics,Huai'an Maternal and Child Health Hospital,Huai'an Jiangsu 223299;School of Mathematics and Statistics,Huaiyin Normal University,Huai'an Jiangsu 223300,P.R.China)

机构地区：[1]南京医科大学第一附属医院产科,江苏南京210029 [2]淮安市妇幼保健院产科,江苏淮安223299 [3]淮阴师范学院数学与统计学院,江苏淮安223300

出　　处：《中国计划生育和妇产科》2025年第1期53-56,共4页Chinese Journal of Family Planning & Gynecotokology

摘　　要：目的基于改良版Robson分级系统分析2020年~2023年淮安市妇幼保健院产妇在不同生育政策时期剖宫产率的变化情况。方法回顾性收集2020年1月至2023年12月在淮安市妇幼保健院住院分娩的26159例育龄产妇的临床资料,应用改良版Robson分级系统对所有产妇进行分类,依据分娩孕周、产次、胎位和胎数等特征分为R1~R8组。计算并比较各组不同年份、不同生育政策时期的剖宫产率及剖宫产产妇人群构成比。结果26159例产妇的总剖宫产率为41.3%(10800/26159),瘢痕子宫再妊娠(R3)的剖宫产率为89.0%(4282/4813),占比最高39.6%(4282/10800)。与二孩政策时期的剖宫产率40.0%(6319/15787)相比,三孩政策时期的剖宫产率升高(43.2%,4481/10372,P<0.05),但在校正母亲年龄后,与二孩政策时期相比,三孩政策时期所有产妇的总体剖宫产风险降低(OR=0.95,95%CI:0.82-0.98),且单胎头位初产妇(R1)、单胎头位经产妇(R2)、单胎早产妇(R8)组剖宫产率均降低(OR=0.89,95%CI:0.81-0.93;OR=0.82,95%CI:0.73-0.88;OR=0.92,95%CI:0.81-0.97)。结论在二孩、三孩政策后,基于改良版Robson分级系统的各类剖宫产率呈上升趋势,高龄和剖宫产术后再妊娠是剖宫产产妇最主要的特点。Objective Based on the modified Robson classification system,the cesarean section in Huai an Maternal and Child Health Hospital from 2020 to 2023 was classified,and the changes of cesarean section rate control in different fertility policies periods were analyzed.MethodsThe clinical data of 26159 parturients in Huai an Maternal and Child Health Hospital from January 2020 to December 2023 were retrospectively collected.All parturients were classified by modified Robson classification system,and divided into R1~R8 groups according to different obstetric characteristics such as gestational age,parity,fetal position and fetal number.Calculated and compared the cesarean section rate and the composition ratio of cesarean section women in different years and different birth policy periods.Results The total cesarean section rate of 26159 parturients was 41.3%(10800/26159),and the cesarean section rate of scar uterus re-pregnancy(R3)was 89.0%(4282/4813),which was the highest among all cesarean sections 39.6%(4282/10800).Compared with the cesarean section rate in the two-child policy period 40.0%(6319/15787),the cesarean section rate in the three-child policy period increased(43.2%,4481/10372,P<0.05).However,after adjusting the mothers age,compared with the two-child policy period,the overall cesarean section risk of all parturients in the three-child policy period decreased(OR=0.95,95%CI:0.82-0.98)and the cesarean section rate of single-child first-time primipara(R1),single-child first-time multipara(R2)and single-childearly parturient(R8)Y was reduced(OR=0.89,95%CI:0.81-0.93,OR=0.82,95%CI:0.73-0.88,OR=0.92,95%CI:0.81-0.97).Conclusions After the two-child,three-child policy,the cesarean section rate based on the modified Robson classificationsystem is on the rise,especially the elderly and re-pregnancy after cesarean section are the most important characteristics of cesareansection women.

关 键 词：改良版Robson分级系统 产妇特征 不同生育政策 剖宫产率 

分 类 号：R719.8[医药卫生—妇产科学]