孕妇要求不合理剖宫产影响因素分析

目的探讨影响孕妇要求不合理剖宫产的相关因素,为孕产期妇女保健工作提供指导。方法采用病例对照研究的方法,对某三级甲等医院2010年6月～2011年6月的产科分娩病案记录进行回顾调查。结果产妇年龄大于35岁、居住在城市、文化程度在本科以上、职业为管理人员或者个体私营业主时,其要求不合理剖宫产的危险性会增加,OR值分别为1.26（1.09,2.01）,2.14（1.47,2.98）,1.55（1.19,2.70）,1.63（1.36,2.89）,1.85（1.47,2.86）。产妇享有医疗保险、剖宫产分娩史以及肥胖（BMI〉29）也是产妇要求不合理剖宫产的危险因素,阴道分娩史是产妇要求不合理剖宫产的保护因素,其OR值分别为2.01（1.26,3.15）,3.89（2.17,6.32）,1.19（1.02,2.01）,0.46（0.21,0.76）。结论应有针对性地加强孕产期妇女保健知识的宣传教育工作,从而控制剖宫产过度使用。

The Analysis of Factors Influencing Pregnant Women Requesting Unreasonable Cesarean Section

Objectives To explore the factors which influence pregnant women requesting unreasonable cesarean section（CS）,and to provide guidance for maternal care.Methods We constructed a case-control study to analyze the medical records of pregnant women who delivered between June,2010 and June 2011.Results Pregnant women with the following characteristics were more likely to request unreasonable CS： older than 35,living in the city,education level above the bachelor degree,administrative staff or private owners,the OR were 1.26（1.09,2.01）,2.14（1.47,2.98）,1.55（1.19,2.70）,1.63（1.36,2.89）,1.85（1.47,2.86）,respectively.Having health insurance,CS delivery history and obesity were risk factors for women to request unreasonable CS,while the vaginal delivery history was protective factors,the OR were 2.01（1.26,3.15）,3.89（2.17,6.32）,1.19（1.02,2.01）,0.46（0.21,0.76）,respectively.Conclusions In order to control the excessive use of CS,it is necessary to strengthen health education for pregnant women.