孕妇分娩方式及其影响因素分析

目的 探讨与孕妇分娩方式相关的生物学因素和精神心理因素,为孕妇在围产期保健中采取更适合自己的分娩方式提供理论依据.方法 通过一对一的问卷调查,收集116例正常孕妇的基本情况、疾病史、个人生活习惯、营养状况以及心理状况等信息,利用单因素分析来筛选与孕妇分娩方式相关的因素,然后将单因素分析有统计学意义的变量引入非条件Logistic回归方程筛选分娩方式的影响因素.结果 本次调查的116例孕妇中,采取自然分娩的有54例,占46.6％；采取剖宫产的有62例,占53.4％.从生物学角度分析,分娩方式与孕前体重、产前体重、体质指数及孕前1年服用维生素或矿物质补充剂均有关(x2分别为:12.59,8.58,12.53,4.41;均有P＜0.05),孕期有主被动吸烟史的孕妇行剖宫产率为60.6％,高于自然分娩率39.4％.从精神心理角度分析分娩方式与SCL-90中的强迫症状、抑郁、阳性项目数有关(P值分别为0.040,0.037,0.039).将以上与分娩方式相关的生理及心理因素引入非条件Logistic回归方程,最终筛选出孕前体重、孕前1年服用维生素或矿物质补充剂为分娩方式的影响因素.结论 应提高对孕妇分娩方式影响因素的重视,加强产前监护,同时有针对性的进行心理干预,从而指导孕妇采取最佳分娩方式.

The analysis of factors associated with delivery mode of pregnant women

Objective To investigate the biological,social and psychological factors related with delivery modes of pregnant women so as to provide theoretical evidence for suitable delivery mode.Methods 116 questionnaires of normal pregnant women were collected,with the general information,history of diseases,life styles,nutritional status and other information.And the factors related with the delivery modes were selected through single factor analysis.And those variables with statistic significance were introduced to the Logistic regression to select the relevant factors associated with delivery modes.Results In 116 questionnaires,54 pregnant women took natural birth mode,accounting for 46.6%,and 62 women chose cesarean delivery,accounting for 53.4%.Biologically,pre-pregnancy weight,prenatal weight,BMI,and vitamin or mineral supplements taken a year before pregnancy were significantly associated with the modes of delivery,with X2 values of 12.59,8.58,12.53 and 4.41 respectively.All P values were less than 0.05.60.6% of the pregnant women who had the passive smoking history and active smoking history during pregnancy period had chosen cesarean section,which was higher than the percentage of spontaneous delivery.In the social and psychological perspective,obsessive compulsive,depression and the number of positive marks in SCL-90 were statistically related with modes of delivery,with P values of 0.040,0.037,and 0.039 respectively.These physiological and psychological factors related with delivery mode were introduced by unconditional Logistic regression equation.Finally,pre-pregnancy weight and vitamin or mineral supplements taken a year before pregnancy were selected as the risk factors. Conclusions Therefore,these factors should be paid attention to in order that the pregnant women can have a suitable mode of delivery.The obsessive compulsive,depression and the number of positive marks in SCL-90 were statistically related with mode of delivery suggests that psychological intervention correspondingly is necessary to low the cesarean section rate.