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中国西南部与现行计划生育政策调整相关的出生和分娩相关产科特征:一项 7 年回顾性研究。

Birth and birth-related obstetrical characteristics in southwestern China associated with the current adjustment of family planning policy: a 7-year retrospective study.

机构信息

Department of Obstetrics, The First Affiliated Hospital of Chongqing Medical University, No. 1 Youyi Road, Yuzhong District, Chongqing, 400016, China.

China-Canada-New Zealand Joint Laboratory of Maternal and Fetal Medicine, Chongqing Medical University, No.1 Yixueyuan Road, Yuzhong District, Chongqing, 400016, China.

出版信息

Sci Rep. 2020 Sep 29;10(1):15949. doi: 10.1038/s41598-020-73039-7.

DOI:10.1038/s41598-020-73039-7
PMID:32994428
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7525438/
Abstract

In China, the adjustment of the family planning policy was expected to increase the number of births and trigger a change in the demographic and obstetrical background of pregnant women. The policy itself, and corresponding background variations of the pregnant mothers, might have various influences on certain birth-related characteristics. Moreover, the adaption of the medical system to the policy needs to be demonstrated. To address these issues, over 50,000 individual records from January 2012 to December 2018 were collected from a large tertiary care centre of southwest China as a representative. The monthly numbers of deliveries and births showed stabilized patterns after remarkable upward trends. Policy-sensitive women, among whom older age and multiparity were typical features, contributed considerably to the remarkable additional births. Indeed, multivariable logistic regression analysis identified the child policy and these two background characteristics as factors influencing CS (caesarean section) rate and certain pregnancy complications or adverse outcomes. After the implementation of the two-child policy, a care provider was faced with fewer but more difficult cases. Briefly speaking, more individual-based studies on family planning policy and more efforts to improve obstetrical service are needed to better guide clinical practice in the new era.

摘要

在中国,计划生育政策的调整预计将增加出生人数,并引发孕妇人口和产科背景的变化。政策本身以及相应的孕妇背景变化可能会对某些与分娩相关的特征产生各种影响。此外,医疗系统需要适应政策。为了解决这些问题,从中国西南部的一家大型三级保健中心收集了 2012 年 1 月至 2018 年 12 月的超过 50,000 份个人记录作为代表。分娩和出生的每月数量在明显上升趋势后呈现出稳定的模式。政策敏感的女性,其中年龄较大和多胎是典型特征,对显著增加的出生人数做出了巨大贡献。事实上,多变量逻辑回归分析确定了儿童政策以及这两个背景特征是影响剖宫产率和某些妊娠并发症或不良结局的因素。二孩政策实施后,医护人员面临的病例虽然减少,但难度更大。简而言之,需要进行更多基于个体的计划生育政策研究,并努力改善产科服务,以便在新时代更好地指导临床实践。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/898b/7525438/e35918fc9ccc/41598_2020_73039_Fig5_HTML.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/898b/7525438/113510450d3a/41598_2020_73039_Fig1_HTML.jpg
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Socioeconomic status can affect pregnancy outcomes and complications, even with a universal healthcare system.社会经济地位会影响妊娠结局和并发症,即使有全民医疗保健系统也一样。
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