降低剖宫产率:2024年至2025年单中心产科质量改进的临床数据报告OA

Objective:To explore the effects of implementing the attending physician responsibility system and obstetric quality management interventions on reducing the cesarean section rate,increasing the spontaneous delivery rate,and improving maternal and neonatal out-comes.Methods:A before-and-after controlled study was conducted.Full-term delivery women in Beijing Tongren Hospital,Capital Medical University,were retrospectively enrolled in 2024(control group,n=2414)and 2025(experimental group,n=2264).The two groups were com-pared in terms of delivery mode,success rate of induction of labor,cesarean section rate,indica-tions for cesarean section,and maternal and neonatal outcomes.Results:In 2025,the spontane-ous delivery rate was significantly higher than in2024(67.1%vs60.3%),while the cesarean section rate(32.9%vs39.7%)and the primary cesarean section rate(31.6%vs 39.8%)were significantly lower(both P<0.001).The proportion of induced labor in 2025 decreased significantly(35.7%vs 42%),and the success rate of induction increased significantly(84.0%vs 80.3%),with statistically significant differences(P<0.001).The leading indica-tion for cesarean section in 2025 remained prior cesarean section(37.9%),but the proportion of"social and other factors"decreased from 32.8%to 19.7%.Rates of neonatal asphyxia,NICU admission,and postpartum hemorrhage did not increase.Conclusion:Implementing the attending physician responsibility system along with systematic obstetric quality interventions-such as strict control of the timing and indications for induction of labor and realtime quality control-can significantly reduce the cesarean section rate and increase the spontaneous delivery rate without increasing maternal and neonatal risks.This provides a feasible approach for obstet-ric quality transformation in the era of low fertility.