Di-san junyi daxue xuebao (Nov 2021)
Rate of cesarean section and its influencing factors in Chongqing during 2010 and 2020
Abstract
Objective To analyze the rate of cesarean section and its influencing factors in Chongqing from 2010 to 2020. Methods A comprehensive survey was adopted based on the Chongqing Obstetrics Quality Questionnaire and the data of birth medical certificate with medical and health institutions which providing midwifery services as the research objects to investigate the current situation of maternal delivery mode selection in the period. Results In 2020, the cesarean section rate of the whole city was 47.59%, with a slight increase of 0.15% compared with that in 2019. The cesarean section rate of first delivery was 43.30%, with 2.29% higher than that in 2019. The proportion of cesarean section without medical indications was 13.20%, which was 19.03% higher than that in 2019. The cesarean section rate was 65.85% for women over 35 years old, which was much higher than that of women under 18 years old (25.91%) and women between 18 and 34 years old (45.61%). The cesarean section rate of private institutions was 51.83%, higher than that of primary institutions (31.69%), secondary institutions (46.11%), tertiary institutions (50.50%) and medical institutions in factories (44.75%). In 2020, the proportion of cesarean section with scarred uterus was the highest (45.57%), followed by elder women (9.73%), fetal distress (8.78%), pregnancy macrosomia (6.67%) and abnormal fetal position (6.43%). Conclusion Scar uterus, elderly women (age ≥35 years), severe complications during pregnancy, macrosomia, fetal distress occupy a large proportion in the indications of cesarean section, which seriously affects the decline of the cesarean section rate. The cesarean section rate, cesarean section rate of first delivery and proportion of cesarean section without medical indications are far higher in private institutions than those of other types of midwifery institutions.
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