【摘要】 目的探讨近20年初产妇剖宫产新生儿窒息率及相关产科因素的变化。方法采用回顾性分析的方法,比较1990-2009年间前10年与后10年初产妇剖宫产新生儿窒息率的差异及初产妇剖宫产新生儿窒息产妇的剖宫产指征的差异。结果 2000-2009年初产妇剖宫产新生儿窒息率较1990-1999年下降(χ2=67.619,P<0.001)。1990-1999年初产妇剖宫产新生儿窒息产妇的剖宫产指征前3位是:难产、胎儿窘迫、前置胎盘及胎盘早剥。2000-2009年初产妇剖宫产新生儿窒息产妇的剖宫产指征前3位是:胎儿窘迫、重度子痫前期、难产。与前10年比较,后10年重度子痫前期、社会因素的构成比升高,难产的构成比下降,差异有统计学意义(均P<0.05)。胎儿窘迫、前置胎盘及胎盘早剥、臀位、双胎、妊娠合并症的构成比差异无统计学意义。结论胎儿窘迫、难产、重度子痫前期是近10年初产妇剖宫产新生儿窒息的主要产科因素。近10年初产妇剖宫产新生儿窒息率下降,剖宫产指征中社会因素的构成比升高值得关注。更多还原

【Abstract】 Objective To analyze the changes of neonatal asphyxia rate and its related obstetric factors in cesarean section primiparas in 20 years.Methods A retrospective analysis was conducted to compare the neonatal asphyxia rates in cesarean section for primiparas and the related indicators of cesarean section from 1990 to 2009.Results The asphyxia rate in cesarean section for primiparas in 2000-2009 decreased significantly compared with that in 1990-1999(χ2=67.619,P<0.001).From 1990 to 1999,the top three leading indicators of cesarean section for primiparas were dystocia,fetal distress,placenta previa and placental abruption in order.From 2000 to 2009,the top three leading indicators of cesarean section for primiparas were fetal distress,severe preecclampsia and dystocia in order.The constituent ratios of social factors and severe preeclampsia increased significantly in 2000-2009 compared with those in 1990-1999(severe preeclampsia:χ2=7.877,P=0.005;social factors:χ2=4.974,P=0.026),while the constituent ratios of dystocia decreased(χ2=7.547,P=0.006).The constituent ratio of fetal distress,placenta previa,placental abruption,breech presentation,twin pregnancy and pregnancy complications in 1990-1999 showed no significant difference from those in 2000-2009.Conclusion Fetal distress,dystocia and severe preecclampsia are the main obstetric factors of cesarean section for primiparas.It’s a concern that the constituent ratio of social factor as an indicator of cesarean section have increased in recent 10 years while the neonatal asphyxia rate in primiparas undergoing cesarean section have decreased.更多还原