边远贫困山区孕产妇住院分娩影响因素分析

目的研究边远贫困山区孕产妇住院分娩影响因素,为下一步制定提高边远山区孕产妇住院分娩率干预措施提供依据。方法采用病例对照研究方法,选取边远贫困山区2010-2011年未住院分娩孕产妇222人为研究组,按同一行政村、同年、同民族,成组匹配217名住院分娩孕产妇为对照组,探讨除交通、经济和民族风俗外的影响住院分娩的因素。结果多因素logistic回归分析显示,第1胎非住院分娩,产检次数,丈夫决定分娩地点,本村有女村医,孕产期保健知识知晓程度,艾滋病、梅毒和乙肝联合检测情况,分娩支付费用是住院分娩的主要影响因素;孕产妇非住院分娩的直接原因位于前4位的依次是预产期提前时间来不及(47.72%),路远、找交通工具困难(14.72%),经济困难(12.18%),身体好没必要上医院(10.15%);非住院分娩中接生人员排在前3位的分别是家人(60.8%)、接生婆(15.8%)和村医(13.5%)。结论边远贫困山区孕产妇住院分娩的影响因素是多方面的,涉及健康教育与健康促进、社会动员、产前检查、转诊及住院分娩或家庭接生等多个环节,须综合干预。

Influencing factors of hospital delivery in remote poverty mountain areas

ObjectiveTo study the influencing factors of hospital delivery in remote and poor mountain areas and to provide basis for promotion of maternal hospital delivery in the remote and poor mountainous areas. MethodsA case-control study was carried out in 222 pregnant wome from remote,impoverished mountain areas and without hospital delivery during 2010-2011 and 217 residential place,year of delivery,and ethnic group-matched controls with hospital delivery.Information on influencing factors of hospital delivery were collected with a face-to-face questionnaire survey. ResultsMultivariate logistic regression analysis showed that having first child of non-hospital delivery,the number of prenatal examination,husband's decision for delivery site,with female village doctor in the village,knowledge about maternal health care,examination results of AIDS,syphilis and hepatitis B,and the cost of hospital delivery were main factors affecting the hospital delivery.The direct cause of non-hospital delivery included without enough time because of preterm delivery(47.72%),far distance from the hospital and difficulty in transportation(14.72%),economic difficulty(12.18%),and thinking of no necessity for hospital delivery because of good health condition(10.15%).The top three birth attendants of non-hospitalized delivery were family member(60.8%),midwife(15.8%),and village doctor(13.5%). ConclusionThe influencing factors of hospital delivery involve health education and health promotion,social mobilization,antenatal care,and transfer of treatment.Comprehensive intervention should be carried out to increase hospital delivery rate in remote mountain area.