| Pregnancy and childbirth are the physiological processes that most women experience.Physiology and psychology of pregnant women will undergo a series of changes.At this time changes in the psychological and physical aspects during pregnancy may increase the risk of various diseases occurring in pregnant women.Pregnancy diseases can seriously affect the physical and mental health of the mother and the fetus.With the continuous adjustment of family planning policies,obstetric diseases have also undergone tremendous changes.How to reduce pregnancy complications and complications,reduce maternal mortality,and protect maternal and child health are important tasks for obstetricians.The disease spectrum can understand the occurrence,distribution,and change of disease in an area.By analyzing the spectrum of the disease,you can understand and master the local epidemic situation and the degree of harm to the population.The current research on the maternal and infant disease spectrum has a small sample size and poor representation,making it difficult to fully understand and analyze the distribution of maternal and child diseases.In recent years,the rate of cesarean section in China has been at a relatively high level.Cesarean section can guarantee the maternal and child safety of high-risk pregnancy and abnormal delivery.However,the risk of diseases such as maternal-infant birth injury and puerperal infections during delivery of cesarean section is higher than that of natural delivery.In addition,the previous studies on the factors affecting cesarean section are mostly including social demographic characteristics,preconception health conditions,and a small number of influential factors during pregnancy.There is less analysis of the impact of various diseases on cesarean section.In light of the above research background,this study was based on the Shandong Province Health and Family Planning Commission Information Center’s 2013-2016 pregnancy and childbirth big data.Descriptive indicators and grade maps were used to fully describe the changes in maternal characteristics,geographic distribution,and cesarean section in Shandong Province.Yield variation and its geographical distribution;based on this,further mapping the mother and infant disease spectrum;using non-conditional logistic regression model to analyze the caesarean factors.To explore the maternal and neonatal diseases to be controlled during maternal and childbirth,and to improve the correct knowledge of cesarean section in relevant departments and pregnant women,with a view to formulating prevention strategies for maternal and child diseases and strictly controlling non-medical indications for cesarean section Implementation provides scientific basis and has certain social and practical value.Result of the study:1.This study included a total of 1,812,987 pregnant and maternity women from 2013 to 2016 in Shandong Province(Elderly mothers accounted for 14.62%),with an average age of 29.3±4.8 years,the median is 29 years old;primipara accounted for 51.30%,and multipara accounted for 48.70%.The multipara ratio during the period was 30.57%,39.41%,46.12%and 53.71%respectively,showing an increasing trend year by year.2.Maternal and fetal disease profile:The top five diseases in the cumulative detection rate,① The maternal system diseases are in turn are blood and hematopoietic organ diseases and diseases involving immune mechanisms(6076.66/100,000),urogenital diseases(1571.49/100,000),and tumors.(961.45/10 million),endocrine and metabolic diseases(781.47/100,000)and respiratory diseases(524.49/100,000).② The maternal diseases in pregnancy,childbirth,and puerperium were:umbilical cord complications during labor and delivery(21204.12/100,000),pelvic organ abnormalities(20357.12/100,000),premature rupture of membranes(14969.05/100,000),amniotic fluid and membrane disease(7548.65/100;000)and gestational diabetes(6405.84/100,000)·③ The fetal and neonatal diseases were:macrosomia(7924.27/100,000),fetal hypoxia(3980.56/100,000),and low birth weight(1206.90/100,000).Perinatal respiratory and cardiovascular diseases(955.77/100,000)and bleeding and blood disorders(687.76/100,000).3.Cesarean section rate and its influencing factors:① The average cesarean section rate of pregnant women in Shandong province from 2013 to 2016 was 36.48%,of which non-medical cesarean section accounted for 25.79%.The top five areas with the highest cesarean section rates were Zhanhua County(65.8%),Gaotang County(62.7%),Bintcheng District of Binzhou City,(62.4%),Wudi County(58.2%),Yangxin County(56.5%).② The main risk factors for cesarean section are:scar the uterus,aplastic anemia,placenta previa,fetal abnormalities and multiple pregnancies,the OR and 95%confidence intervals were 10.626(10.529,10.725),7.966(5.691,11.150),6.088(5.864,6.321),5.861(5.764,5.961)and 5.154(5.028,5.284);High education is a protective factor for cesarean section.Conclusion:1.The multipara ratio showing an increasing trend in Shandong Province.2.Maternal diseases that should be controlled in Shandong Province are mainly anemia during pregnancy,umbilical cord complications,pelvic organ abnormalities,premature rupture of membranes,amniotic fluid and other diseases of the fetal membranes,gestational diabetes mellitus;Huge children,signs of fetal hypoxia,low birth weight.3.The rate of cesarean section in Shandong Province is high,and one quarter of them are non-medical cesarean sections.Scarring of the uterus,placenta previa and abnormal fetal position are major risk factors for cesarean section. |
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