| ObjectiveAnalyze the current situation of cesarean section and study the main influencing factors of cesarean section.Understand the cognition of delivery mode,attitude and behavior of the pregnant woman.Improve the level of maternal knowledge,and provide scientific basis for further reducing the cesarean section rate and optimizing the delivery outcome.MethodFirst of all,the research was conducted based on the information in the first page of medical records from January 1,2011 to June 30,2019,and to analyze the demographic distribution characteristics,mode of delivery,influencing factors,and hospitalization expenses,etc.χ2 test was used to compare the differences of each variable between vaginal delivery and cesarean section,and univariate logistic regression was used to analyze the relationship between each research factor and cesarean section.In the multivariate logistic regression model,the stepwise regression method was used to further analyze the influencing factors of cesarean section.The research choose random samples from hospitalization for delivery of pregnant women from June 16 2017 to November 30,2017,using the method of questionnaire survey to investigate their cognition,attitude and behavior of the childbirth way.χ2 test was used to compare the differences between the variables of vaginal delivery and cesarean section.Univariate logistic regression was used to analyze the influence of related factors on cesarean section.the multivariate logistic stepwise regression was used to further analyze the related factors affecting maternal selection of cesarean section.Results1.A total of 35,437 hospitalized mothers were investigated from January 1,2011 to June 30,2019,with an average age of 30.47 years old,and the annual cesarean section rate was 4.64 years old,and a baby boom between 25 and 30 years old.2.From 2011 to 2016,the annual cesarean section rate was 58.05%,57.40%、57.57%、54.46%、58.44%、57.29%,57.83%、56.54%and 58.28%,respectively.3.The average hospitalization cost of the puerpera was 11977.56 yuan,and the standard deviation was 7575.91 yuan,among which the number with the hospitalization cost above 5000～10000 yuan was the most(33.36%);All kinds of hospital expenses of cesarean section patients are higher than those of vaginal delivery patients,and the difference between drug cost and health material cost is the largest.4.After multivariate logistic regression analysis,the OR value and 95%confidence interval of parturient women with unweighted head and pelvis,scar uterus,placenta previa,multiple pregnancy,gestational hypertension,age over 35 years old were443.09(143.16,1371.44),31.66(28.16,35.60),21.69(15.73,29.92),16.33(13.13,20.30)and 10.40(8.75,12.36)。5.Only 34.90%,26.70%and 20.90%of the pregnant women knew about the process of childbirth,the influencing factors of childbirth and how to deal with the discomfort of childbirth,respectively.The results of multivariate logistic regression analysis showed that pregnant women were more likely to choose the way of delivery recommended by doctors.Compared with "the doctor recommended vaginal delivery",the RR value and 95%confidence interval of "the doctor recommended cesarean section" and "the doctor did not recommend cesarean section" were 312.21(156.23,623.94)and 10.60(6.26,17.95),respectively.Conclusion1.The composition of caesarean sections in each year from 2011 to 2019 was higher than 50%.2.The hospitalization cost of cesarean section was higher than that of vaginal delivery.3.Factors influencing cesarean section include age,maternal factors,fetal and placental factors,and common factors of the mother and the child.Among them,parturient women with unknown head and pelvis,scar uterus,placenta previa,multiple pregnancy,gestational hypertension are the main risk factors for cesarean section.4.Pregnant women have a low awareness of the delivery mode,and they are more likely to choose the delivery mode recommended by doctors. |
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