中国妇幼健康研究2017，Vol.28Issue(12)：1566-1569,4.DOI:10.3969/j.issn.1673-5293.2017.12.021
上海市低风险孕产妇二孩分娩意愿与方式的对比研究
Comparative research on delivery willingness and actual delivery mode of second child in low-risk parturients in Shanghai
摘要
Abstract
Objective To compare delivery willingness and actual delivery mode between low-risk primipara and second birth parturients so as to explore influencing factors of cesarean section .Methods Two hundred low-risk pregnant women in late pregnancy were chosen in each district of 8 districts of Shanghai from May to July in 2013 .Baseline questionnaire and postpartum follow-up survey were conducted in them .Study subjects were divided into primipara group and second birth parturient group . Demographic and socioeconomic data ,childbirth education and awareness of childbirth knowledge ,willingness of delivery and its causes ,and actual delivery modes were collected .Results Finally 1559 valid questionnaires were obtained including questionnaires of 1299 primiparaes and 260 second birth parturients ..Cesarean section rate of second birth parturients (51 .50％ ) was higher than that of primiparaes (41 .80％ ) (χ2 = 8 .604 ,P = 0 .014) .There were statistically significant differences in terms of age ,mother's education level , whether parturient was the only child , maternity insurance , expense reimbursement , willingness of delivery between two groups (χ2 value was 63 .12 ,62 .33 ,31 .60 ,35 .99 and 14 .04 ,respectively ,all P < 0 .01 ) .Multivariate regression analysis showed that four factors including willingness of delivery (OR = 1 .562 ,95％ CI :1 .181 - 2 .051 ,P = 0 .000) ,maternal and fetal factors (OR = 2 .380 ,95％ CI :1 .127 - 5 .028 ,P = 0 .023) ,mother's education level (OR = 0 .531 ,95％ CI :0 .322 - 0 .874 ,P =0 .044) ,whether parturient was the only child (OR = 0 .611 ,95％ CI :0 .433 - 0 .863 , P = 0 .031) entered the Logistic regression model ,in which willingness of delivery and maternal and fetal factors were the most important risk factors of cesarean section ,but whether primiparous or multiparous women was not composition of main risks .There was no significant difference in reasons for choosing cesarean section except physical factors in two groups ,and fear of suffering for the second time ,worry about safety ,and fear of pain were main reasons .Conclusion Both for primipara or second birth parturient ,willingness of delivery is important factor of cesarean section .Insufficient knowledge and prejudice against natural childbirth are the main reasons for preference of cesarean section .It is recommended that obstetric health providers should continuously improve popularity and quality of prenatal childbirth education ,offer effective assessment and consulting for women's birth intention ,and help them to reduce the fear of childbirth and establish the confidence of natural childbirth .Cesarean section indications should be strictly controlled to reduce cesarean section rate .关键词
初产孕产妇/二胎孕产妇/分娩意愿/分娩方式/影响因素Key words
primipara/second birth parturient/willingness of delivery/delivery modes/influencing factors分类
医药卫生引用本文复制引用
雷洁,朱丽萍,花静,曹志娟..上海市低风险孕产妇二孩分娩意愿与方式的对比研究[J].中国妇幼健康研究,2017,28(12):1566-1569,4.基金项目
国家自然科学基金资助项目(81402687,81673179) （81402687,81673179）
上海市科学技术委员会资助项目(14411970900,15495810500) （14411970900,15495810500）
上海市公共卫生三年行动计划重点学科人才资助项目(15GWZK0401) （15GWZK0401）
江苏省高等职业院校教师专业带头人高端研修资助项目(2016GRFX053) （2016GRFX053）
