Impact Of Using Maternal And Child Health Care Apps During Pregnancy On Adoption Of Caesarean Section

Objective: To explore the impact of using maternal and child mobile Apps on reducing the caesarean section rate,and evaluate the effect of maternal and child health care Apps on caesarean section.Methods: We collected question-naires and patients’ medical history of terminated maternal women in 6 maternal and child hospitals(3 each in Beijing and Hebei)in part of Northern China from Oct 2017 to Jan 2018.To cover different types of hospitals,we selected the hospitals from one core urban area,two suburban areas,two outer suburban areas,and one county area.In the whole hospital or the study of obstetrics,selected the women who meet the inclusion criterion according to the order of delivery.Collected the people basic characteristics including age,educational background,pregnancy times,production times,past medical history.Exposure factors such as maternal and child health Apps use or not,frequency of use,and the time of starting use,etc.Caesarean section related information such as whether there is a caesarean section indications,etc.We checked the distribution of continuous variables,used mean and standard deviation(X ±S)to describe normally distributed variables and median and quantile [M(QR)] to describe skewed variables.For categorical variables,such as education,family income,time to start using Apps,etc.We used frequency n(%)to illustrate.The impact factors of caesarean section were analysed using dichotomous non-conditional Logistic regression.Enter and stepwise regression analysis(Forword:LR)was used for multivariate analysis,and the variable of unordered multiclassification was performed.The inclusion level of variable screening was 0.05,and the rejection level was 0.10.Simultaneously,the correlation intensity OR value of each influencing factor and caesarean section were calculated,and the corresponding 95%CI was calculated.The test level was 0.05.Results: In 1863 maternal women,a total of 792(42.5%)delivered caesarean section this time,including 689(37.0%)who had an indication of caesarean section and 103(5.5%)who had no indication of caesarean section.A total of 1,403 maternal women equipped and use maternal and child health Apps,the utilization rate reached 75.3%.The use of maternal and child health Apps and Logistic regression of cesarean section showed,compared to unused maternal and child health care App people,the continuous use of maternal and child health App’s OR=0.632,95%CI(0.445,0.899),P=0.011.Intermittent use of maternal and child health App’s OR=0.953,P=0.760,the difference was not considered statistically significant.Maternal and child health App usage and Logistic regression with indications of cesarean section,Reference to unused maternal and child health Apps,continuous use of maternal and child health App’s OR=0.651,95% CI(0.441,0.960),P=0.030.Intermittent use of maternal and child health App’s OR = 0.986,P = 0.935,it cannot be considered statistically significant yet.There was no significant difference in the effect of maternal and child health App and use of maternal and child health App on non-indicative cesarean section.Conclusion: Persistence in the use of Maternal and Child Health App has a positive impact on reducing the rate of cesarean section and indicted cesarean section,but the use of the maternal and child health care Apps’ impact on non-indicative cesarean section were not statistical significant.