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Construction of a prediction model and a prevention control system for cesarean section rate based on the Robson
1Department of Obstetrics and Gynecology, Xingtai People's Hospital Xingtai, Hebei Province, China.
Objective:
To systematically explore the risk factors that influence cesarean section rate, and establish a prediction model to investigate a system effectively reducing cesarean section rates.
Methods:
This retrospective study was carried out in the medical institutions in Xingtai city, where cesarean section could be conducted. The data of parturients who gave birth to children in the past five years were collected using the hospital information system. Based on the Robson's ten group classification system, parturients were grouped. The difference of cesarean section rate in each group and its main influencing factors were then analyzed. The above factors and factors such as age, education background, and knowledge on childbirth were independent variables, while cesarean section was the dependent variable. A logistic regression model was constructed to determine the correlation between relevant influencing factors and cesarean section.
Results:
In the past 5 years, cesarean section rate in Xingtai city had been maintained at a relatively high level. Cesarean section rates in the R2 and R5 groups were the highest. Parity, fetal position, number of fetuses, and gestational weeks were all factors affecting cesarean section rate (all P < 0.01). After screening the above factors using logistic regression analysis, a regression equation was established: logistic (p) = -1.061 + 1.107 * parity + 0.196 * fetal position + 2.245 * number of fetuses - 0.070 * gestational week + 0.234 * age - 0.278 * education background + 0.623 * knowledge on childbirth.
Conclusion:
The Robson classification system plays an important role in evaluating and supervising parturients' conditions. Based on the Robson classification system, we find that parity, fetal position, number of fetuses, and gestational weeks are the main factors influencing cesarean section rate. Using logistic regression analysis, a prediction model, with guiding significance on the control of cesarean section rate, is established.
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