Occurrence of cesarean section and related factors in 40 counties of China from 1978 to 2010 / 中华预防医学杂志

ABSTRACT

<p><b>OBJECTIVE</b>To find out the occurrence of cesarean section (CS) and related factors among child-bearing women in China.</p><p><b>METHODS</b>The survey was conducted during October, 2010 in 40 counties selected from 30 provinces. Size proportional sampling method was employed in sampling. A face to face questionnaire investigation was conducted among 8 420 women who experienced pregnancies from 1978 to 2010. Information on demographic characteristics, history of pregnancy and birth were obtained, and related factors of CS occurrence were analyzed.</p><p><b>RESULTS</b>A total of 11 440 living births have been given by 8 420 women, and 1 725 CS happened. As the time goes on, there is a growing trend of CS occurrence, from 2.0% (14/701) in 1978-1985 to 36.6% (813/2 224) in 2006-2010, and there is a most fast increase from 2001 to 2010. CS rate in Mid-China (42.3%, 257/608) is the highest from 2006 to 2010. And also, the rate of CS requested by the pregnant women or their family members was increasing year by year, from 14.3% (2/14) in 1978-1985 to 43.7% (255/813) in 2006-2010. Women who were above 25 years old (21.4%, 960/4 485) , with an education degree of high school or above (24.5%, 568/2 317), engaged in nonagricultural work (22.4%, 663/2 956), living in eastern provinces of China (18.6%, 757/4 074), fetal malposition (45.4%, 247/544) , with a heavier birth weight(4 000 gram or above) (36.5%, 175/479) , have accepted B ultrasound exam (18.8%, 1 633/8 687) with an increasing of blood pressure (28.0%, 172/614) and convulsion experiences (24.8%, 131/528) during pregnancy were more likely to have CS.</p><p><b>CONCLUSION</b>The CS rate among child-bearing women in China was rather high, and was related with factors of demographic characteristics(age of childbearing, education, vocation, residence) and some medical factors(neonatal weight, having accepted B ultrasound exam, fetal malposition, an increase of blood pressure and convulsions during pregnancy).</p>