| ObjectiveTo understand the current situation of the rate of cesarean section, to explore the main risk factors affecting the rate of cesarean section in Liaocheng city, and to provide a theoretical basis for reducing the rate of cesarean section and optimizing delivery outcome.MethodsUsing random sampling method,3000 cases of pregnant women in Liaocheng city maternal and baby health care and Dongchangfu district maternal and baby health care were randomly selected. The patients with a history of mental illness, severe physical illness (not including pregnancy complications), refused cooperation and inability to read the questionnaire were excluded. Using self-designed questionnaire, and anxiety self-rating scale (SAS), personal basic situation of pregnant women, pregnancy and delivery and psychological status were investigated and analyzed, The obstetrician general situation questionnaire by each maternal corresponding obstetrician to fill out independently, the cesarean section rate was compared by using χ2 test and influencing factors analysis was used by multi factor non conditional logistic regression analysis.Results1 The research results of pregnant women1.1 The general situation of pregnant women1.1.1 Analysis on the personal basic situation of pregnant women3000 cases of pregnant women were investigated, among them,1304 cases were cesarean section, and cesarean section rate was 43.5%.30 years old of pregnant women accounted for 75.7%, pregnant women in rural areas accounted for 61.6%, the junior middle school education level accounted for 36.3%, career as a housewife accounted for 49.3%.1.1.2 Analysis on social factors of pregnant womenThe survey found that pregnant women who come from Liaocheng city maternal and baby health care accounted for 33.3%, pregnant women who come from Dongchangfu district maternal and baby health care accounted for 66.7%. 2000 yuan of family per capita monthly income accounted for 50.5%, and 82.9% had the close relationship with husband, pregnant women who were satisfaction with family housing accounted for 95%, and no family history of genetic disease accounted for 96.9%1.1.3 Analysis on the situation of pregnant womenThe survey found that pregnant women at term (38 to 42 weeks) accounted for 86.8%, planned to be pregnant accounted for 58.8%, pregnant women did not do abortion before the pregnancy accounted for 38.6%, without complications of pregnant women accounted for 95.9%, greater than or equal to 5 times of prenatal examination accounted for 62.8%, prenatal examination was often accounted for 80.7%.1.1.4 Analysis on influence factor of choosing delivery mode of pregnant womenThe survey found that the delivery cost of pregnant women was completely at their own expense accounted for 80.9%, pregnant women’s relatives and friends had unsuccessful delivery accounted for 17.3%, pregnant women were afraid of the feeling accounted for 73.7%, pregnant women was very trust in the hospital accounted for 92.9%, pregnant women tend to be natural delivery accounted for 73.8%, and the cause was their own ideas of pregnant women accounted for 45.5%.1.1.5 Analysis on the fear of maternal laborThe survey found that pregnant women never worried about the baby’s sex accounted for 90.8%, pregnant women were a bit worried about the safety of babybirth accounted for 67.6%, pregnant women were a little worried about the health of the baby accounted for 59.4%, there are 52.3% pregnant women never worried about the size of the change.1.1.6 Analysis on the anxiety situation of pregnant womenThe survey found that 48.4% of pregnant women had anxiety. There were significant differences of maternal anxiety in different cultures, different occupations and different family economic conditions. Among them, the level of primary school education, business staff, and 500 yuan of family per capita monthly income had the most serious anxiety, and the prevalence of anxiety respectively accounted for 71.1%,100% and 59.6%.1.2 Analysis on single factor of the maternal cesarean section rate1.2.1 Analysis on the influence of individual basic situation on the rate of cesarean sectionThe survey found that there were significant differences of the cesarean section rate in different maternal age, nationality, education level, and occupation (χ2=39.413～288.091,p=0.000). Among them, the higher the age, the rate of cesarean section was the higher. The rate of cesarean section in the Han nationality was lower than that of other nationalities. The cesarean section rates of the farmers and the degree of education in the primary school of maternal were relatively high.1.2.2 Analysis on the influence of social factors on the rate of cesarean sectionThe survey found that there were significant differences of the cesarean section rate in different family income per month, different relationship with her husband, her husband’s behavior, different satisfactory with family housing, and family history of genetic disease (χ2=20.145～186.372, P=0.000). Among them, the family per capita monthly income was below 500 yuan, the relationship was general with her husband, the husband’s behavior had verbal abuse/shame/threat, was not satisfied with family housing, and had a family history of genetic disease, and the cesarean section rates were higher.1.2.3 Analysis on the influence of maternal pregnancy conditions on the rate of cesarean sectionThe survey found that there were significant differences of the cesarean section rate in different gestational age, pre pregnancy BMI index, BMI index after pregnancy, the pregnancy was planned or unplanned pregnancy, the abortion number of the pre pregnancy, the complications of pregnancy, the number of prenatal examination, and the situation of prenatal examination (χ2=16.828～ 129.690, P=0.000). Among them, at term of gestational age (38 to 42weeks), the rate of cesarean section was lower. The rate of cesarean section was higher than that of the unexpected pregnancy. There were 2 times of abortion, no complications during pregnancy, the number of prenatal examination was less than 5 times, and the prenatal examination was abnormal, and the rate of cesarean section was higher.1.2.4 Analysis on the influence factor of choosing delivery modes on the rate of cesarean sectionThe survey found that there were significant differences of the cesarean section rate in different the medical expenses of delivery, the delivery situation of relatives and friends, the trust of hospital, the trend of delivery mode, and the cause of delivery (χ2=17.193～1034.181, P=0.000). Among them, the more trust on hospital, the rate of cesarean section was lower. Relatives and friends did not have a smooth birth rate was higher than that of relatives and friends were not successful delivery situation. Completely self-expense, the trend of delivery was the caesarean section, and the rate cesarean section was higher.1.2.5 Analysis on the factors of maternal labor fear on the rate of cesarean sectionThe survey found that there were significant differences of the cesarean section rate in whether to worry about the baby’s sex, whether to worry about the safe of birth, whether to worry about the baby’s health, whether to worry about the size of the change(χ2=13.057～65.732, P=0.000). Among them, never worried about the sex of the baby, very worried about the safety of baby birth, very worried about the health of the baby, and the cesarean section rate was very higher.1.2.6 Analysis on the influence of the anxiety situation on the rate of cesarean sectionThe survey found that there were significant differences of the cesarean section rate in different anxiety situation (χ2=331.008,P=0.000). Among them, the rate of cesarean section in pregnant women with anxiety was significantly higher than those without anxiety.2 The research results of the obstetrics doctors2.1 The general situation of the obstetrics doctorsThe survey found that the obstetrics doctors accounted for 12.2% under the age of 30 years old; there was 82.8% 30 to 45 years old, and there was 5.0% over 46 years old. The college degree of the obstetrics doctors accounted for 33.3%, Bachelor degree of the obstetrics doctors accounted for 66.7%. Resident physician accounted for 40.5%, attending doctor accounted for 58.4%.5 years of working experience and the following accounted for 34.5%,5 ～ 10 years accounted for 36.2%, more than 10 years accounted for 29.3%.2.2 Analysis on the influence of general situation factors on the cesarean section among the obstetrics doctorsThe survey found that there were significant differences of the cesarean section rate in different age, different education, different titles, and different working years (χ2=58.234-626.492, P=0.000). Among them, the age in 30 to 45 years old, more than 10 years of working experience, and the rate of cesarean section was higher. The cesarean section rate of college degree was higher than the bachelor degree of the obstetrics doctors. The higher the professional title of doctors, the choosing probability rate of the cesarean section was the higher.3 Analysis on multi factors of the maternal cesarean section rateThe survey found that the maternal age, BMI index, family income per month, relationship with her husband, family history of genetic disease, the pregnancy was planned pregnancy or pregnancy, delivery situation of relatives and friends, the feeling of the delivery, the delivery trust on the hospital, the trend of the delivery, the cause of the baby health concerns, whether anxiety, prenatal examination was abnormal or not, the doctor’s working age were risk factors. Among them, maternal age was older, the pregnant BMI index was higher, per capita monthly income of family was higher, relations with her husband was general, a family history of genetic disease, the pregnancy was unwanted pregnancies, relatives and friends were not smooth delivery, the feeling that was not terrible on delivery, trust on hospital was general, trend of delivery mode was caesarean section, the cause of delivery mode was the doctor suggested, were worried about baby health, prenatal anxiety, prenatal examination was abnormal, and practitioners experience more than 10 years and so on were the risk factors of the rate of cesarean section. BMI index of pre pregnancy, family-sources, education, occupation, the number of pre pregnancy abortion, the medical expenses of delivery, whether the fear of baby sex, whether the fear of babybirth safety, doctors education, doctors title, and the number of prenatal examination were the protection factors. Among them, the BMI index was higher, the family was rural, university of education, occupation was enterprise staff, the number of pre pregnancy abortion was 2 times, the medical expenses of delivery was the new rural cooperative medical expenses, worried about baby sex sometime, very worried about the delivery safety, doctor degree was undergraduate, the number of prenatal examinationwas 5 times and the doctor title were protection factors of the rate of cesarean section.Conclusion1. The cesarean section rate of pregnant women was relatively high in Liaocheng city,43.5%。2.The age of maternal was older, BMI was greater after pregnancy, and per capita monthly income of family was higher, relations was general with her husband, a family history of genetic disease, the pregnancy was unwanted pregnancies, relatives and friends had smooth delivery, felt not terrible to delivery, the generally trust to bisect babybirth hospital, the trend of delivery mode was caesarean section, the etiology of birth was the doctor suggested, were worried about baby health, prenatal anxiety, prenatal examination was abnormal, the working life of doctor was more than 10 years, and so on, were the main risk factors of the maternal cesarean section.3. BMI index was greater before pregnancy, family sources were rural, education level, occupation was the enterprise staff, the number of pre pregnancy abortion was 2 times, the medical expenses was the new rural cooperative medical expenses, worried about baby gender sometime, worried about delivery safety very much, medical history was associate chief physician, the number of prenatal examination was 5 times, and the doctor title, the eleven factors were the protection factors of cesarean section. |
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