Lu X H, Huang X H
Beijing Obstetrics and Gynecology Hospital.
Zhonghua Fu Chan Ke Za Zhi. 1994 Aug;29(8):453-5, 508.
In order to evaluate the effect of cesarean section on reduction of perinatal mortality rate (PMR). All cases delivered in Beijing Obstetrics and Gynecology Hospital from Jan. 1, 1980 to Dec. 31, 1992 were analysed. The total number of delivery in study period was 74,199. Number of cesarean section delivery was 18,557. The cesarean section rate was 25.0%. The total number of perinatal baby was 74,914. The number of perinatal death was 1,140. PMR was 15.2%. The 13 years were divided into three periods to compare the cesarean section rate and PMR. The 1st period was from 1980 to 1984. The 2nd period was from 1985 to 1988. Years from 1989 to 1992 were 3rd period. The cesarean section rate was increasing year by year. It was significant since 1985. On the other hand, the PMR was marked decreasing since 1983. But there was no continually decrease in 2nd period. In 3rd period trend of decreasing PMR was shown. There was no significant difference in PMR especially in neonatal mortality rate (NMR) between cesarean section group and vaginal delivery group in 1st period. In 2nd period the PMR and NMR of cesarean section group was higher than that of vaginal delivery group (P < 0.01). In 3rd period it was lower in cesarean section group (P < 0.05). Main causes of neonatal deaths in cesarean section group were congenital abnormalities and respiratory diseases. In 2nd period pulmonary hemorrhage, hyaline membrane disease were marked higher in cesarean section group. It was related to more premature and low birth weight babies in this group.(ABSTRACT TRUNCATED AT 250 WORDS)
为评估剖宫产对降低围产儿死亡率(PMR)的效果,对1980年1月1日至1992年12月31日在北京妇产医院分娩的所有病例进行了分析。研究期间分娩总数为74199例,剖宫产分娩数为18557例,剖宫产率为25.0%。围产儿总数为74914例,围产儿死亡数为1140例,PMR为15.2%。将这13年分为三个时期以比较剖宫产率和PMR。第一个时期为1980年至1984年,第二个时期为1985年至1988年,1989年至1992年为第三个时期。剖宫产率逐年上升,自1985年起显著上升。另一方面,自1983年起PMR显著下降,但在第二个时期并非持续下降。在第三个时期呈现出PMR下降的趋势。在第一个时期,剖宫产组和阴道分娩组的PMR尤其是新生儿死亡率(NMR)无显著差异。在第二个时期,剖宫产组的PMR和NMR高于阴道分娩组(P<0.01)。在第三个时期,剖宫产组较低(P<0.05)。剖宫产组新生儿死亡的主要原因是先天性异常和呼吸系统疾病。在第二个时期,剖宫产组的肺出血、透明膜病明显更高。这与该组中更多的早产儿和低体重儿有关。(摘要截短于250字)