[摘要] 目的 探讨剖宫产率及剖宫产指征变迁对围产儿死亡率的影响。方法 对10年间剖宫产病例资料进行回顾分析。结果 1993至1997年剖宫产率为30.34%，显著低于1998至2002年的45.30%，两者比较差异有极显著性(P<0.01)。在剖宫产指征中，妊娠并发(合并)症始终处于第1位，社会因素上升为第2位，头盆不称为第3位，胎儿窘迫为第4位。围产儿死亡率1993至1997年为16.85‰，1998至2002年为17.79‰，两者比较，差异无显著性(P>0.05)。结论 剖宫产率升高在一定范围内降低了围产儿死亡率，但随着剖宫产率的进一步升高，围产儿死亡率并未随之下降。因此，应合理掌握剖宫产指征，降低剖宫产率。

    [关键词] 剖宫产;围产儿死亡率

    Relationship of caesarean section rate and changes of cesarean section indications with perinatal mortality of the newborn

    LUO Yu-fang, CHEN Su-mei

    (Department of Gynecology and Obstetrics, Xingning People's Hospital, Xingning 514500, Guangdong Province, China)

    Abstract: Objective To explore the effects of cesarean section rate and changes of cesarean section indications on the perinatal mortality rate. Methods Data from 3 635 patients undergoing cesarean section in our hospital from January 1993 to December 2002 were analyzed retrospectively. Results The cesarean section rate in 1993 - 1997 was 30.34%, significantly lower than that in 1998 - 2002 (45.3%, P < 0.01). In the cesarean section indications, complications of pregnancy, social factors, malposition, and fetal distress were at the first, second, third, and fourth place, respectively. The perinatal motality rate in 1993 - 1997 (16.85‰) was not significantly different from that in 1998 - 2002 (17.79‰) (P > 0.05) Conclusion The increased cesarean section rate can reduce the perinatal mortality rate within a certain range, but further rise of cesarean section rate does not result in the corresponding decrease of the perinatal mortality rate. Therefore, we should have a good grasp of cesarean section indications and decrease cesarean section rate. ......