摘要目的 探讨城市流动人口群体产妇意外分娩影响因素及影响效度,以优化城市妇幼保健政策措施,降低流动人口产妇意外分娩的发生.方法 选择2016年1月至2017年7月某医院接诊的218例流动人口意外分娩产妇为观察组,同期同城住院分娩的814例孕产妇为对照组.采用非条件Logistic逐步回归分析流动人口意外分娩的相关影响因素及影响效度.结果 通过1 032例产妇数据分析,流动人口受教育程度、家庭人均月收入、孕早期检查、定期产检率、围保建档、保类型及孕产保健知识缺失是造成意外分娩的影响因素(P ＜0.05或P＜0.01);经济因素、社保福利低及妇幼保健资源利用不足是意外分娩发生的独立影响因素(P ＜0.05或P＜0.01);流动人口经产妇心理轻视是意外分娩发生的间接影响因素(P ＜0.05或P＜0.01).结论 统筹放开流动人口医保异地报销政策,统筹城乡生育保险制度,是降低城市流动人口产妇意外分娩发生,可行措施.

abstractsObjective To investigate influential factors on accidental delivery of pregnant women in floating population and its efficacy,so as to optimize urban maternal and child health strategy and reduce the occurrence of unintentional delivery among migrant mothers.Methods Pregnant and maternal women among urban migrant population were enrolled as research objects.Two hundred and eighteen women who had accidental delivery in the same city from January 2016 to July 2017 were selected as the observation group,and 814 migrant women who had delivery in hospital within the same time span were designated as the control group.Non-conditional logistic stepwise regression was used to analyze influential factors and validity of unintentional delivery among floating population.Results Analysis of the data of 1032 parturients indicated that educational background,average monthly income,early pregnancy examination,rate of regular maternity examination,archiving of perinatal insurance,type of insurance and lack of knowledge on maternal health care among the floating population were obviously the main factors leading to accidental delivery(P ＜ 0.05 vs P ＜0.01).Economic factors,low social security benefits and insufficient utilization of maternal and child health care resources were the main independent influential factors of accidental delivery (P ＜ 0.05 vs P ＜ 0.01).Psychological neglect by migrant women was an independent influential factor of accidental delivery (P ＜0.05).Conclusion To reduce the occurrence of unintentional delivery,we should liberalize the reimbursement policy of medical insurance for floating population in different places and coordinate the birth insurance system in urban and rural areas.