目的了解临床实际中选择剖宫产术分娩所参考的胎儿出生体重范围,为进一步降低剖宫产率、提升围产期保健服务质量提供依据。方法选取《广东省出生医学证明管理信息系统》中2017年1月1日-12月31日分娩的足月单胎活产新生儿及其产母作为研究对象,分析新生儿出生体重分布、巨大儿发生率以及与剖宫产率的关系。结果剖宫产率为30.6%(540 641/1 766 153),新生儿平均出生体重(3194±402)g,低出生体重<2500 g发生率为2.8%(49 672/1 766 153),巨大儿(出生体重≥4000 g)发生率为3.2%(55 893/1 766 153),出生体重介于2500～3499 g之间的占73.9%(1 304 677/1 766 153),出生体重介于3500～3999g的占20.2%(355 911/1 766 153)。以新生儿出生体重介于2500～3499 g为对照,低出生体重组剖宫产率高于对照组,差异具有统计学意义(P <0.001);当出生体重≥3600 g时,剖宫产率高于对照组,并随着出生体重的增加剖宫产率有上升趋势,差异有统计学意义(P <0.001)。结论胎儿出生体重偏低或过高均影响分娩方式的选择,应加强孕期健康宣教及体质量增长的院内和院外连续监测管理。

Objective Understand the reference range of fetal birth weight in clinical practice,so as to provide a basis for further reducing the rate of cesarean section and improving the quality of perinatal health care services.Methods Full-term singleton live births and their mothers delivered from January 1,2017 to December 31,2017 in Guangdong Medical Certificate Management Information system were selected as the object of study.The relationship between the distribution of birth weight,the incidence of macrosomia and the rate of cesarean section were analyzed.Results The cesarean section rate was 30.6%(540 641/1 766 153).The average birth weight of newborns was(3194±402) g.The incidence of low birth weight(<2500 g) was 2.8%(49 672/1 766 153),and the macrosomia(birth weight≥4000 g) incidence rate was 3.2%(55 893/1 766 153) Birth weight between 2500 to3499 g accounted for 73.9%(1 304 677/1 766 153).Birth weight between 3500 to 3999 g accounted for 20.2%(355 911/1 766 153).Compared with the newborn birth weight of(2500-3499) g,the cesarean section rate of low birth weight group was higher than that of the control group.The difference was statistically significant(P <0.001),when the birth weight was≥3600 g,the cesarean section rate was higher than the control group,and the cesarean section rate increased with the increase of birth weight,and the difference was statistically significant(P <0.001).Conclusion Lower or higher birth weight of the fetus affects the choice of delivery mode,and the continuous monitoring and management of in-hospital and out-hospital health promotion and body weight growth during pregnancy should be strengthened.