湖南省产妇分娩方式及其影响因素分析

目的 了解湖南省产妇生产方式及其影响因素，为制订促进自然分娩的干预措施提供依据。方法 采用分层整群随机抽样方法，对2011年5月1日—2012年5月1日在湖南省6所不同等级医院分娩的603名产妇进行问卷调查。结果 所调查产妇平均年龄为（27.55±4.179）岁，文化程度本科及以上者占28.17%，32.48%有流产史，24.38%为经产妇，剖宫产率为53.89%，自然分娩率为46.11%；每次都能按时接受产前检查者占51.01%，28.88%的产妇产前检查结果异常，17.42%被医生建议剖宫产，12.86%参加孕妇学校；多变量logistic回归结果显示，影响剖宫产的主要因素为产妇期望剖宫产（OR=33.118，90%CI=11.274~95.514）、丈夫期望剖宫产（OR=6.055，90%CI=2.919~13.297）、选择市级医院分娩（OR=1.708，90%CI=1.078~2.932）、医生建议剖宫产（OR=19.851，90%CI=4.666~81.460）。结论 目前湖南省的剖宫产率较高，产妇参加孕妇学校、按时接受产前检查的比例也较低，孕妇及其家属的自然分娩相关健康教育工作有待加强。

Delivery ways and associated factors among lying-in women in Hunan province

Objective To explore delivery ways and its associated factors among lying-in women in Hunan province,and to provide evidence for future natural delivery intervention activities.Methods Stratified cluster randomized sampling was used to investigate 603 lying-in women with deliveries between May 1st,2011 and May 1st,2012 in six hospitals in Hunan province.Results The average age of the 603 women was 27.55±4.179 years.Among the women 28.17% obtained college education or higher,32.48% had history of abortion,and 24.38% had a delivery.The current prevalence of caesarean section was 53.89% and that of vaginal delivery was 46.11% for the women.There were 51.01%of the women attending prenatal examination in time,28.88% being identified with abnormal condition during the prenatal examination,17.42%being suggested to choose caesarean by the doctors and only 12.86% taking part in the school for pregnant women.The results of multivariable logistic regression revealed that the main factors associated with caesarean section were the willingness for caesarean section of the pregnant woman(odds ration[OR]=33.118,90% confidence interval[90%CI]:11.274-95.514),the husband's willingness for caesarean section(OR=6.055,90%CI:2.919-13.297),delivery in a hospital at city level(OR=1.708,90%CI:1.078-2.932),and doctors' recommendation to caesarean section(OR=19.851,90%CI:4.666-81.460).Conclusion The prevalence of caesarean section was high and the percentage of pregnant women participating pregnant women school or attending prenatal examination in time was low in Hunan province,suggesting health education related to natural delivery should be strengthened.