Objectives To analyze the variation tendency of delivery mode in recent 10 years, and identify the relation between elective cesarean sections and postpartum maternal complications. Methods A retrospective cohort study was conducted. We investigated the medical records of hospital delivery women in a hospital of Wuhan from 2001 to 2010. The association between elective cesarean sections and maternal outcome was estimated for women by odds ratios (ORs) , adjusted for potential confounders. Results 1 1350 women/deliveries were surveyed. Of them, 48. 56% were m vaginal delivery group, 13. 42% in medical indicator group, 19. 91% had a cesarean section in labor, and 18. 11% had elective cesarean section. The total cesarean section rate was 51. 44% and increased from 45. 63%to 54.82% from 2001 to 2010. The elective cesarean section rate increased from 1 3. 77% to 22. 63% in recent 10 years. Taking into account potential confounders such as age, education level, elective cesarean section was associated with higher risk of hysterectomy (QR = 1. 42; 95%CI:1. 13~1. 86) , obstetric shock (OR = 2. 37; 95% CI:1. 44~4. 25) and anesthetic complications (QR = 2. 68; 95%CI:1. 5 1~4. 72) compared to women in the vaginal delivery group. Conclusions Cesarean section rate gradually rose, and selective cesarean section may be the main reason. Elective cesarean section was associated with a higher risk of postpartum maternal complications. This suggests there is a need for a program to reduce unnecessary elective cesarean sections.%目的 分析近10年来产妇分娩方式的变化趋势,并确定选择性剖宫产(亦称社会因素剖宫产)与产后并发证的关系.方法 采用回顾性研究方法,对武汉市某医院2001~2010年10年内住院分娩产妇的病史资料进行调查分析.结果共查阅分析了11 350例住院分娩产妇的病史资料,48.56%的产妇采用阴道自然分娩,医学指征剖宫产、试产后剖宫产以及选择性剖宫产分别占13.42%、19.91%和18.11%,总的剖宫产率为51.44%.10年内选择性剖宫产率由13.77%升高到22.63%,总的剖宫产率由45.63%升高到54.82%.相对于选择自然分娩的产妇来说,选择性剖宫产的产妇更可能会发生产后子宫切除(OR=1.42;95%CI:1.13~1.86)、产中休克(OR=2.37;95%CI:1.44~4.25)和麻醉相关并发证(OR=2.68;95%CI:1.51~4.72).结论 10年内剖宫产率逐渐升高,选择性剖宫产增多是其主要原因.选择性剖宫产会增加一些严重产后并发证的危险性,我国急需针对选择性剖宫产制定相应的干预政策和措施.
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