The incidence, risk factors and maternal and foetal outcomes of uterine rupture during different birth policy periods: an observational study in China
Abstract Background Currently, there are no studies on changes in the incidence of uterine rupture or maternal and foetal outcomes in women with uterine rupture during different birth policy periods in China. Moreover, the results of association studies of maternal age, parity and previous caesarean...
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doaj-57b92f4851da4760a5097c214137343e2021-05-09T11:17:38ZengBMCBMC Pregnancy and Childbirth1471-23932021-05-0121111010.1186/s12884-021-03811-8The incidence, risk factors and maternal and foetal outcomes of uterine rupture during different birth policy periods: an observational study in ChinaYangwen Zhou0Yi Mu1Peiran Chen2Yanxia Xie3Jun Zhu4Juan Liang5National Office for Maternal and Child Health Surveillance of China, West China Second University Hospital, Sichuan UniversityNational Office for Maternal and Child Health Surveillance of China, Department of Obstetrics, West China Second University Hospital, Sichuan UniversityNational Office for Maternal and Child Health Surveillance of China, West China Second University Hospital, Sichuan UniversityNational Office for Maternal and Child Health Surveillance of China, West China Second University Hospital, Sichuan UniversityNational Office for Maternal and Child Health Surveillance of China, West China Second University Hospital, Sichuan UniversityNational Office for Maternal and Child Health Surveillance of China, West China Second University Hospital, Sichuan UniversityAbstract Background Currently, there are no studies on changes in the incidence of uterine rupture or maternal and foetal outcomes in women with uterine rupture during different birth policy periods in China. Moreover, the results of association studies of maternal age, parity and previous caesarean section number with the risk of maternal and foetal outcomes in women with uterine rupture have not been consistent. This research aims to conduct and discuss the above two aspects. Methods We included singleton pregnant women with no maternal complications other than uterine rupture from January 2012 to June 2019 in China’s National Maternal Near Miss Surveillance System. The data in this study did not differentiate between complete and partial uterine rupture and uterine dehiscence. Through Poisson regression analysis with a robust variance estimator, we compared the incidences of uterine rupture and maternal and foetal outcomes in women with uterine rupture during different birth policy periods in China and determined the relationship between maternal age, parity or previous caesarean section number and uterine rupture or maternal and foetal outcomes in women with uterine rupture. Results This study included 8,637,723 pregnant women. The total incidences of uterine rupture were 0.13% (12,934) overall, 0.05% during the one-child policy, 0.12% during the partial two-child policy (aRR = 1.96; 95% CI: 1.53–2.52) and 0.22% (aRR = 2.89; 95% CI: 1.94 4.29) during the universal two-child policy. The maternal near miss and stillbirth rates in women with uterine rupture were respectively 2.35% (aRR = 17.90; 95% CI: 11.81–27.13) and 2.12% (aRR = 4.10; 95% CI: 3.19 5.26) overall, 5.46 and 8.18% during the first policy, 1.72% (aRR = 0.60; 95% CI: 0.32–1.17) and 2.02% (aRR = 0.57; 95% CI: 0.37–0.83) during the second policy, and 1.99% (aRR = 0.90; 95% CI: 0.52–1.53) and 1.04% (aRR = 0.36; 95% CI: 0.24–0.54) during the third policy. The risk of uterine rupture increased with parity and previous caesarean section number. Conclusion The uterine rupture rate in China continues to increase among different birth policy periods, and the risk of maternal near miss among women with uterine rupture has not significantly improved. The Chinese government, obstetricians, and scholars should work together to reverse the rising rate of uterine rupture and improve the pregnancy outcomes in women with uterine rupture.https://doi.org/10.1186/s12884-021-03811-8Uterine ruptureBirth policyIncidenceRisk factorsPregnancy outcomes |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Yangwen Zhou Yi Mu Peiran Chen Yanxia Xie Jun Zhu Juan Liang |
spellingShingle |
Yangwen Zhou Yi Mu Peiran Chen Yanxia Xie Jun Zhu Juan Liang The incidence, risk factors and maternal and foetal outcomes of uterine rupture during different birth policy periods: an observational study in China BMC Pregnancy and Childbirth Uterine rupture Birth policy Incidence Risk factors Pregnancy outcomes |
author_facet |
Yangwen Zhou Yi Mu Peiran Chen Yanxia Xie Jun Zhu Juan Liang |
author_sort |
Yangwen Zhou |
title |
The incidence, risk factors and maternal and foetal outcomes of uterine rupture during different birth policy periods: an observational study in China |
title_short |
The incidence, risk factors and maternal and foetal outcomes of uterine rupture during different birth policy periods: an observational study in China |
title_full |
The incidence, risk factors and maternal and foetal outcomes of uterine rupture during different birth policy periods: an observational study in China |
title_fullStr |
The incidence, risk factors and maternal and foetal outcomes of uterine rupture during different birth policy periods: an observational study in China |
title_full_unstemmed |
The incidence, risk factors and maternal and foetal outcomes of uterine rupture during different birth policy periods: an observational study in China |
title_sort |
incidence, risk factors and maternal and foetal outcomes of uterine rupture during different birth policy periods: an observational study in china |
publisher |
BMC |
series |
BMC Pregnancy and Childbirth |
issn |
1471-2393 |
publishDate |
2021-05-01 |
description |
Abstract Background Currently, there are no studies on changes in the incidence of uterine rupture or maternal and foetal outcomes in women with uterine rupture during different birth policy periods in China. Moreover, the results of association studies of maternal age, parity and previous caesarean section number with the risk of maternal and foetal outcomes in women with uterine rupture have not been consistent. This research aims to conduct and discuss the above two aspects. Methods We included singleton pregnant women with no maternal complications other than uterine rupture from January 2012 to June 2019 in China’s National Maternal Near Miss Surveillance System. The data in this study did not differentiate between complete and partial uterine rupture and uterine dehiscence. Through Poisson regression analysis with a robust variance estimator, we compared the incidences of uterine rupture and maternal and foetal outcomes in women with uterine rupture during different birth policy periods in China and determined the relationship between maternal age, parity or previous caesarean section number and uterine rupture or maternal and foetal outcomes in women with uterine rupture. Results This study included 8,637,723 pregnant women. The total incidences of uterine rupture were 0.13% (12,934) overall, 0.05% during the one-child policy, 0.12% during the partial two-child policy (aRR = 1.96; 95% CI: 1.53–2.52) and 0.22% (aRR = 2.89; 95% CI: 1.94 4.29) during the universal two-child policy. The maternal near miss and stillbirth rates in women with uterine rupture were respectively 2.35% (aRR = 17.90; 95% CI: 11.81–27.13) and 2.12% (aRR = 4.10; 95% CI: 3.19 5.26) overall, 5.46 and 8.18% during the first policy, 1.72% (aRR = 0.60; 95% CI: 0.32–1.17) and 2.02% (aRR = 0.57; 95% CI: 0.37–0.83) during the second policy, and 1.99% (aRR = 0.90; 95% CI: 0.52–1.53) and 1.04% (aRR = 0.36; 95% CI: 0.24–0.54) during the third policy. The risk of uterine rupture increased with parity and previous caesarean section number. Conclusion The uterine rupture rate in China continues to increase among different birth policy periods, and the risk of maternal near miss among women with uterine rupture has not significantly improved. The Chinese government, obstetricians, and scholars should work together to reverse the rising rate of uterine rupture and improve the pregnancy outcomes in women with uterine rupture. |
topic |
Uterine rupture Birth policy Incidence Risk factors Pregnancy outcomes |
url |
https://doi.org/10.1186/s12884-021-03811-8 |
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