| Objectives The use of intraspinal analgesia in Hebei Province and the influence of intraspinal analgesia on mothers and infants were analyzed.Methods A cross-sectional study method was used to collect 289895 people from 22 monitoring hospitals in the Critical Maternal Monitoring Information Management System of Hebei Maternal and Child Health Center from January 1,2013 to December 31,2017.According to the inclusion and exclusion criteria,165219 cases were excluded,and the remaining 124676 cases were divided into neuraxial analgesia delivery(NAD)group and spontaneous vaginal delivery(SVD)group.Compare two groups of general information.According to the three distribution characteristics,the use of intraspinal analgesia in different years,different regions,and different groups of people was compared between the two groups.The maternal and infant outcomes were performed for primipara and postpartum women in the two groups.Excel software was used to establish a database,and SPSS 26.0 software was used for statistical analysis of data.Measurement data are expressed as median and interquartile range,using Mann-Whitney rank sum test;counting data are expressed as constituent ratio,using chi-square test or adjusted chi-square test;using multivariate logistic regression to analyze intraspinal analgesia.The relationship with maternal and infant outcomes,while adjusting the confounding factors.The Adjusted RR value and 95% confidence interval were used to evaluate the influence of intraspinal analgesia on maternal and infant outcomes.P<0.05 indicates that the difference is statistically significant.Results 1 From 2013 to 2017,among pregnant women who gave birth via vagina,5220 people used intraspinal analgesia,and the utilization rate was 4.19%(5220/124676).2From 2013 to 2017,the birth rate in Hebei Province fluctuated,but the use rate of intraspinal analgesia first decreased and then increased.3 Among hospitals of different levels,although the delivery rate in the second-level hospital is the highest(53.5%),the use rate of spinal analgesia in the third-level hospital(6.8%)is far higher than that of the second-level hospital(2.0%).The lower the hospital level,the lower the use rate of intraspinal analgesia is;the use rate of intraspinal analgesia in different cities is different,the population distribution is large,and the use rate of medical resources in Shijiazhuang is more equitable,reaching 7.9%.Zhangjiakou is the lowest,reaching 0.0%.4 Among pregnant women of different ages,the childbirth rate is the highest(68.4%)in marriage and childbirth of the right age(68.4%);there is no statistically significant difference in the use rate of intraspinal analgesia in different gestational weeks;there are differences in the use rate of intraspinal analgesia in pregnant women with different years of education,and the higher the number of years of education,the higher the usage rate of intraspinal analgesia.5 By adjusting the age,pregnancy times,parity,pregnancy complications,years of education,delivery hospital level confounding factors,a multivariate logistic regression analysis showed taht,in primiparas,intraspinal analgesia is an independent risk factor for the use of oxytocin drugs.Adjusted OR(95%CI): 1.951(1.568,2.427),P<0.001;in transspinal analgesia,intraspinal analgesia is an independent risk factor for the use of oxytocin drugs.Adjusted OR(95%CI): 1.302(1.016,1.669),P<0.001;whether it is a primipara or a postpartum,intraspinal analgesia had no effect on uterine weakness,placental abruption,premature abruption,postpartum hemorrhage,blood product infusion,systemic infection of the whole body,and had no effect on the Apgar score of newborns at1 min,5 min,and 10 min,and neonatal death.Conclusions 1 From 2013 to 2016,the use of the spinal canal in Hebei Province first declined and then increased.With the opening of the second child policy in 2016,the use of the spinal canal increased significantly in 2017.2 Intraspinal analgesia has the highest usage rate in tertiary hospitals.Shijiazhuang has the highest rate of intraspinal analgesia.It is necessary to coordinate the allocation of medical resources in various regions,especially in large and sparsely staffed areas.3 The use rate of intraspinal analgesia is the highest among people of the right age,full-term people,and people with higher education level,so delivery analgesia should be promoted in a targeted manner.4 Intraspinal analgesia is an independent risk factor for increasing the use of oxytocin drugs in primiparous and postpartum women;however,it has no significant effect on the outcome of pregnant women and neonates.Figure 9;Table 10;Reference 121... |
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