中国“单独二孩”政策实施前后剖宫产率的变化趋势。
Trends in Cesarean Delivery Rate after Cessation of the One-Child Policy in China.
机构信息
Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, People's Republic of China.
Department of Obstetrics, International Peace Maternity & Child Health Hospital, Shanghai Jiaotong University Medical School, Shanghai, People's Republic of China.
出版信息
Am J Perinatol. 2021 Aug;38(S 01):e84-e91. doi: 10.1055/s-0040-1705176. Epub 2020 Mar 20.
OBJECTIVE
We aimed to describe changes in cesarean delivery (CD) rates after the change of the one-child policy in China by using the Robson classification in a large Chinese population.
STUDY DESIGN
This retrospective cohort study included 91,015 women who delivered at ≥24 weeks of gestation at a large tertiary obstetric center in Shanghai, China from 2011 to 2016. We analyzed CD rate trend and CD contribution trend in each Robson group. Logistic regression was used to calculate the odds of CD while adjusting for confounding variables.
RESULTS
The overall CD rate decreased from 49.0% in 2011 to 40.6% in 2016. In nulliparous women with singleton cephalic term pregnancy and planned CD, the CD contribution rate was reduced significantly from 29.3% in 2011 to 16.4% in 2016 ( < 0.001). In multiparous with a scarred uterus, the CD contribution rate began to increase from 3.8% in 2011 to 9.1% in 2016 ( < 0.001). Compared with delivery in 2011, delivery in 2016 was associated with a 37% (adjusted odds ratio [aOR]: 0.63; 95% confidence interval [CI]: 0.60-0.66) reduction in CD. This reduction was observed in both nulliparous women with singleton cephalic term pregnancy (aOR: 0.57; 95% CI: 0.54-0.60), and multiparous women with singleton cephalic term pregnancy without scar (aOR: 0.41; 95% CI: 0.30-0.55).
CONCLUSION
The rate of cesarean delivery in our Chinese population has declined significantly in the past few years.
目的
我们旨在通过在中国大型人群中使用 Robson 分类法描述中国一孩政策改变后剖宫产率的变化。
研究设计
本回顾性队列研究纳入了 2011 年至 2016 年在中国上海一家大型三级产科中心≥24 周妊娠分娩的 91015 名妇女。我们分析了每个 Robson 组中剖宫产率趋势和剖宫产术贡献趋势。使用逻辑回归在调整混杂变量后计算剖宫产的比值比（OR）。
结果
总体剖宫产率从 2011 年的 49.0%降至 2016 年的 40.6%。在初产妇、单胎头位妊娠且计划行剖宫产的妇女中，剖宫产术的贡献率从 2011 年的 29.3%显著降至 2016 年的 16.4%（<0.001）。在有瘢痕子宫的多产妇中，剖宫产术的贡献率从 2011 年的 3.8%开始增加至 2016 年的 9.1%（<0.001）。与 2011 年相比，2016 年分娩与剖宫产率降低 37%（调整后的 OR：0.63；95%置信区间 [CI]：0.60-0.66）相关。这种减少在初产妇单胎头位妊娠（OR：0.57；95% CI：0.54-0.60）和无瘢痕多产妇单胎头位妊娠（OR：0.41；95% CI：0.30-0.55）中均观察到。
结论
在过去几年中，中国人群的剖宫产率显著下降。
Zotero 插件