选择性引产与产妇要求：一项全国性基于人群的研究。

Elective induction of labour and maternal request: a national population-based study.

机构信息

INSERM UMR 1153, Obstetrical, Perinatal and Paediatric Epidemiology Research Team, Centre for Epidemiology and Statistics (U1153), DHU Risk in Pregnancy, Paris-Descartes University, Paris, France.

Perinatal Epidemiology and Reproductive Health Unit, Ecole de Santé Publique, Université Libre de Bruxelles, Brussels, Belgium.

出版信息

BJOG. 2016 Dec;123(13):2191-2197. doi: 10.1111/1471-0528.13805. Epub 2015 Nov 30.

DOI:10.1111/1471-0528.13805

PMID:26615965

Abstract

OBJECTIVE

To estimate the rate of elective inductions in France and the proportion of them that were maternally requested, and to study the factors associated with elective inductions that were or were not requested by women.

DESIGN

Cross-sectional population-based study.

SETTING

All maternity units in France.

POPULATION

About 14 681 women from the 2010 French National Perinatal Survey of a representative sample of births.

METHODS

Inductions were classified as elective based on their indications and maternal and fetal characteristics, collected from medical records. Elective inductions requested by women were identified from the mother's postpartum interviews. Polytomous logistic regression analysis was used to study the determinants of inductions that were or were not maternally requested. Women with spontaneous labour served as the comparison group.

MAIN OUTCOME MEASURE

Rate of elective inductions.

RESULTS

The induction rate was 22.6, 13.9% elective. Among elective inductions, 47.3% were requested by women. The characteristics of mothers, pregnancies, and maternity units were similar in both groups of elective inductions. The main associated factors were parity 2 or more [adjusted odds ratio (OR) 4.7, 95% confidence interval (CI) 3.1-7.2 for maternally requested inductions and aOR of 1.8 (95% CI1.2-2.7) for unrequested inductions, compared with parity 0] and private hospital status [aOR 4.5 95% (CI 3.3-6.0) for maternally requested inductions and aOR 3.7 (95% CI 2.8-4.9) for inductions not requested by the mother]. We found no association between maternal social characteristics and type of elective induction.

CONCLUSION

Parity and organisational factors appear to influence the decision about elective inductions. It would be interesting to determine how obstetricians and women make this decision and for what reasons.

TWEETABLE ABSTRACT

About 13.9% of inductions of labour were elective in France, 47.3% of these requested by women.

摘要

目的

估计法国选择性引产的比例以及其中由产妇要求的比例，并研究与产妇要求或不要求的选择性引产相关的因素。

设计

基于人群的横断面研究。

地点

法国所有的产科单位。

人群

来自法国 2010 年全国围产儿调查的约 14681 名产妇。

方法

通过从病历中收集的指征和母婴特征，将引产归类为选择性引产。从产妇的产后访谈中确定产妇要求的选择性引产。多分类逻辑回归分析用于研究要求或不要求引产的决定因素。自然分娩的产妇作为对照组。

主要结局指标

选择性引产率。

结果

引产率为 22.6%，其中 13.9%为选择性引产。在选择性引产中，47.3%由产妇要求。两组选择性引产的产妇、妊娠和产科单位特征相似。主要相关因素为产次≥2（产妇要求的引产校正比值比[aOR]为 4.7，95%置信区间[CI]为 3.1-7.2，而未要求的引产 aOR 为 1.8（95% CI 1.2-2.7），与产次 0 相比）和私立医院地位（产妇要求的引产 aOR 为 4.5，95% CI 为 3.3-6.0，而产妇未要求的引产 aOR 为 3.7，95% CI 为 2.8-4.9）。我们没有发现产妇社会特征与选择性引产类型之间的关联。