两个孩子政策如何影响晚产妇 (AMA) 妇女的剖腹产:使用罗布森分类系统
Wenting Tang1,2, Daidi Zeng1,2, Wanhua Wu1,2
1Department of Obstetrics and Gynecology, The Tenth Affiliated Hospital of Southern Medical University (Dongguan people's hospital), 78# Xinguchong, Wandaolunan, Wanjiang District, Dongguan, Guangdong, 523059, China.
BMC pregnancy and childbirth
|October 4, 2024
概括
剖腹产率在中国的两子政策下,随着母亲年龄的提高,剖腹产率显著增加. 年龄较大的母亲,特别是40岁以上的母亲,面临更高的风险,特别是在特定的罗布森组.
科学领域:
- 产科和妇科 产科和妇科
- 孕产妇和胎儿医学 孕产妇和胎儿医学
- 公共卫生政策 公共卫生政策
背景情况:
- 中国实施双子政策影响了母亲人口统计.
- 先进的孕产妇年龄 (AMA),通常定义为35岁或以上,与产科风险增加有关.
- 剖腹产 (CS) 仍然是一个重要的分娩方法,在全球和根据人口因素的不同率.
研究的目的:
- 调查母亲晚年和剖腹产率之间的关联.
- 在中国的两个孩子政策的背景下,分析与孕产妇年龄有关的CS趋势.
- 确定特定的产科群体,有助于在老年母亲中提高CS率.
主要方法:
- 通过使用东人民医院 (2017-2020) 的数据进行了一项回顾性队列研究.
- 包括20岁及以上的女性,具有特定的妊娠年龄和出生体重标准.
- 用修改的罗布森分类系统分析了剖腹产率和贡献率,并通过千平方测试和患病率比较进行统计比较.
主要成果:
- 在47654名女性中,整体CS率为40.64%.
- 与年轻的母亲 (36.10%) 相比,35-39岁和40岁以上的母亲的CS率显著更高 (分别为57.90%和64.75%).
- 40岁以上的女性在罗布森组1中患CS的可能性是3倍,在组10中患CS的可能性是1.76倍;组2'也在AMA组中显示出显著更高的CS率.
结论:
- 剖腹产率显示出明显的上升趋势,因为在两个孩子政策下,母亲的年龄在增加.
- 修改后的罗布森分类突出了AMA女性的特定高风险群体,包括原发性妇女,子宫痕妇女和多胎妊娠妇女.
- 建议针对这些已识别的高风险AMA子组提供有针对性的关注和管理策略,以潜在地减轻CS率.
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