2009年北京地区剖宫产率及影响因素

目的:了解北京地区剖宫产率,探讨剖宫产的相关因素。方法:抽取北京地区7个区县的9家医院,回顾性调查2009年1~9月期间在医院分娩的2 308例产妇的分娩信息,并对4家医院的24例住院产妇和12位产科医生进行定性小组访谈。结果:①2009年北京地区医院的剖宫产率为51.1%,三级医院高于一、二级医院(55.0%∶48.9%)。②多元Logistic回归分析显示,高危妊娠、具有本市户籍、分娩巨大儿者,其剖宫产的可能性大;与25岁组相比,34岁组、25~34岁组剖宫产的可能性增高。③小组访谈结果显示,剖宫产率偏高的原因包括医学因素和社会因素。结论:北京地区剖宫产率偏高,社会因素为主要因素之一;应从多方面着手,降低社会因素的剖宫产率。

The rate of cesarean section and its effect factors in Beijing in 2009

Objective:To understand the rate of cesarean section in Beijing,explore the related factors of cesarean section.Methods:2 308 pregnant women delivering from January to September in 2009 were selected from 9 hospitals in 7 districts in Beijing,their delivery information was investigated retrospectively,24 pregnant women and 12 obstetricians were selected to attending the focus group discussions in 4 hospitals.Results:The rate of cesarean section was 51.1% in Beijing in 2009,the rate in tertiary hospitals was higher than those in primary and secondary hospitals(55.0% vs.48.9%).Multiple Logistic regression analysis indicated that the pregnant women with high risk pregnancy,local household registration and fetal macrosomia had high possibility of cesarean section;compared with <25 years old group,the possibility of cesarean section in >34 years old group and 25~34 years old group increased.The results of focus group discussions showed that the reasons of high cesarean section rate included both medical factors and social factors.Conclusion:The rate of cesarean section is relatively high in Beijing,social factors are the main reasons,which should be controlled in many aspects.