摘要
收集2017年1月1日至2019年12月31日在南京市妇幼保健院就诊的74038例孕产妇相关信息,以其分娩结局(即剖宫产和生理产)为切入点,分析3年剖宫产率的变化情况,并以2017年为基线,通过多因素分析探查政策施行当年和第二年的效果。总体上,3年在南京市妇幼保健院就诊的74038名孕产妇的剖宫产率呈现下降趋势(线性趋势卡方检验,χ^(2)值为51.708,P<0.001),但根据孕产妇是否高龄(≥35岁)和是否首次分娩分为四类(非高龄非首次分娩孕产妇、非高龄首次分娩孕产妇、高龄非首次分娩孕产妇和高龄首次分娩孕产妇)后发现,仅有非高龄首次分娩孕产妇的剖宫产率存在下降趋势。在多因素分析中,2018年的剖宫产率为2017年的0.890倍,2019年的剖宫产率为2017年的0.869倍,一定程度上可以说明和反映《南京市高危孕产妇管理规范》对于控制35岁以下首次分娩孕产妇的剖宫产率有作用,但对于高危孕产妇的作用并未显现,还需进一步研究和政策完善。
A total of 74038 pregnant women who visited Nanjing Maternity and Child Health Care Hospital from January 1,2017 to December 31,2019 were collected.Take their delivery outcomes(i.e.cesarean section and physiological birth)as the starting point,analyze the changes of cesarean section rate in three years,and take 2017 as the baseline to explore the effect of the policy in the year and the second year through multivariate analysis.In general,the cesarean section rate of 74038 pregnant women who visited Nanjing Maternal and Child Health Hospital in three years showed a downward trend(linear trend chi square test,χ^(2) was 51.708,P<0.001).However,according to whether the pregnant women were old(≥35 years old)and whether they gave birth for the first time,it was found that only the cesarean section rate of the pregnant women who gave birth for the first time had a downward trend.In multivariate analysis,the cesarean section rate in 2018 was 0.890 times than that in 2017,and the cesarean section rate in 2019 was 0.869 times than that in 2017.To a certain extent,it can be explained and reflected that the management code of Nanjing high risk pregnant women management standard has an effect on controlling the cesarean section rate of first⁃time pregnant women under the age of 35,but it has no effect on high⁃risk pregnant women,further research and policy improvement are needed.
作者
陈曦
王锦帆
CHEN Xi;WANG Jinfan(School of Health Policy and Management,Nanjing Medical University,Nanjing 211166;Medical Services Section,Women’s Hospital of Nanjing Medical University(Nanjing Maternity and Child Health Care Hospital),Nanjing 210004;School of Marxism,Nanjing Medical University,Nanjing 211166,China)
出处
《南京医科大学学报（社会科学版）》
2021年第4期372-377,共6页
Journal of Nanjing Medical University（Social Sciences）
基金
南京医科大学人文医学协同创新中心课题“医学与人文融合的教案教学式沟通方案研究”(nrmxc201703)。
关键词
孕产妇
分娩方式
影响因素
管理规范
pregnant women
mode of delivery
influencing factors
management specification
作者简介
陈曦(1991-),男,江苏南京人,硕士研究生在读,研究方向为卫生管理;通信作者:王锦帆(1960-),男,江苏南京人,教授,研究方向为医患沟通,yhgt2013@njmu.edu.cn。
