Use Of The 10-group Classification System To Explore How The Population-control Policy Change In China Has Affected Cesarean Delivery

Objective: To explore the effect following the relaxation of China’s population-control policy on the cesarean delivery(CD)rate using the 10-Group Classification System(TGCS)and reduce the CD rate in China.Method: A retrospective study included 9734 deliveries at the first affiliated hospital of Soochow university,during 2013–2016.The deliveries were classified by the TGCS.The deliveries were separated into three subgroups,T1(before the selected two-child policy was conducted),T3(after the universal two-child policy was conducted),T2(interval between the two policies).?2 tests and logistic regression were chosen to Statistical analysis.Results: There was 3909 caesarean sections in the deliveries.The contribution of group 2b and group 5 to the overall CD rate was approximately 50%.The overall CD rate decreased from T1(43.71%)to T3(34.29%)(adjusted for age OR: 0.603,95%CI:0.532-0.685).The largest contributor to the overall CD rat-e was group 2b(T3 vs.T1,5.35% vs.14.27%,P<0.05).The contribution of grou-p 1 and group 2 significant decreased(T3 vs.T1,50.24% vs.60.34%,P<0.05).The contribution of group 3 and group 4 increased(T3 vs.T1,21.66% vs.16.71%,P<0.05).The contribution of group 5 significant increased(T3 vs.T1,14.47% vs.9.28%,P<0.05).Conclusion: With China ending its one-child policy,the contribution of multiparous deliveries(including women with previous cesarean)significant increase while the overall CD rate significant decrease in recent 4 years.The group 2b and group 5 will be the mainly controlling population to reduce the CD rate in China.The 10-Group Classification System can be used as an effective tool to study the change of cesarean section rate after the the population-control policy.