CAJ | 학술논문

目的：探讨入院待产时间对剖宫产分娩的影响，为进行入院待产时间的管理和降低剖宫产率提供依据。方法选取2004年1月—2013年12月在本院产科住院分娩的产妇为研究对象，采用病例对照的研究方法，以剖宫产分娩的产妇为病例组，阴道分娩为对照组，比较两组人群入院待产时间是否存在差异。同时采用多因素分析调整剖宫产指征、产妇年龄、婴儿性别等因素对两者关联的影响。结果阴道分娩组有90.0%（1243/1381）的产妇入院待产时间≤3 d，高于剖宫产组的73.2%（1447/1978），差异有统计学意义（ Z=170.064，P<0.01）。Logistic回归分析显示，年龄越大〔>34岁比<20岁，OR =2.75，95%CI（1.45，5.22）〕、产前有剖宫产指征〔OR =6.00，95%CI（5.09，7.09）〕、入院待产时间越长〔>7 d比0 d，OR=4.14，95%CI（2.86，5.97）〕，产妇剖宫产分娩的可能性也增加（P<0.05）。结论产妇分娩年龄越大、分娩前有剖宫产指征、入院待产时间越长，越有可能选择剖宫产分娩。
목적：탐토입원대산시간대부궁산분면적영향，위진행입원대산시간적관리화강저부궁산솔제공의거。방법선취2004년1월—2013년12월재본원산과주원분면적산부위연구대상，채용병례대조적연구방법，이부궁산분면적산부위병례조，음도분면위대조조，비교량조인군입원대산시간시부존재차이。동시채용다인소분석조정부궁산지정、산부년령、영인성별등인소대량자관련적영향。결과음도분면조유90.0%（1243/1381）적산부입원대산시간≤3 d，고우부궁산조적73.2%（1447/1978），차이유통계학의의（ Z=170.064，P<0.01）。Logistic회귀분석현시，년령월대〔>34세비<20세，OR =2.75，95%CI（1.45，5.22）〕、산전유부궁산지정〔OR =6.00，95%CI（5.09，7.09）〕、입원대산시간월장〔>7 d비0 d，OR=4.14，95%CI（2.86，5.97）〕，산부부궁산분면적가능성야증가（P<0.05）。결론산부분면년령월대、분면전유부궁산지정、입원대산시간월장，월유가능선택부궁산분면。
Objective To explore the association between early admission in labor and cesarean delivery so as to pro-vide references for the management of the early admission in labor and the drop of cesarean delivery rate. Methods In the study, puerperal women were selected in this hospital from Jan. 2004 to Dec. 2013. A case-control study was used to compare the differ-ence of early admission in labor between the two delivery methods:cesarean delivery( case group)and vaginal birth( control group). Multi-factor analysis was used for the influences of adjusting cesarean section indicators,maternal age,infant gender and other factors over the association. Results The ratio of early admission in labor,which was less than 3 days,accounted for 90. 0%(1 243/1 381) in vaginal delivery group,which was higher than 73. 2%(1 447/1 978) in cesarean group,with sig-nificant difference(Z=170. 064,P<0. 01). The logistic regression analysis showed that pregnant women,with old age〔 >34 years old vs. <20 years old,OR=2. 75,95%CI(1. 45,5. 22)〕,having cesarean section indicators〔(OR=6. 00,95%CI (5. 09,7. 09)〕,longer early admission in labor〔 >7 days vs. 0,OR=4. 14,95%CI(2. 86,5. 97)〕,were more likely to choose cesarean delivery(P<0. 05). Conclusion Pregnant women,with old age,having cesarean section indicators and lon-ger early admission in labor,were more likely to choose cesarean delivery.