苏婷婷，AU - JOUR AU - Heitner, AU - Jesse, AU - Yuan, AU - zheng, AU - Si，王亚飞，AU - Zhou, AU - Dan, AU - ying, Zhongliang PY - 2020 DA - 2020/11/3 TI -基于短信的教育干预对中国孕妇剖宫产率的影响准随机对照试验手机短信服务手机短信准随机对照试验移动医疗背景:普遍认为适当的地区剖宫产率不应超过新生儿的15%，但中国部分地区剖宫产率超过50%，要求降低剖宫产率的呼声很高。目前，中国2016年的二孩政策加剧了全国剖宫产趋势的影响。目的:本研究利用中国公民普遍使用的手机来测试低成本和可扩展的产前咨询项目对剖宫产率的影响。方法:参与者是在中国西安一家诊所接受产前护理的孕妇。分配采用准随机化方法，以准妈妈的生日为依据，采用阶乘分配。参与者被分配到以下四组中的一组，每一组都收到一组不同的信息:(1)只收到一些“基本”信息的对照组，(2)主要接收有关寻求护理的信息的组，(3)主要接收有关良好家庭产前习惯的信息的组，以及(4)接收所有组的短信的组。信息在整个怀孕期间传递，并根据每个妇女的妊娠周量身定制。主要结果是干预组报告的剖宫产率。数据分析人员对治疗分配不知情。 Results: In total, 2115 women completed the trial and corresponding follow-up surveys. In the unadjusted analysis, the group receiving all texts was associated with an odds ratio of 0.77 (P=.06), though neither the care seeking nor good home prenatal practice set yielded a relevant impact. Adjusting for potentially confounding covariates showed that the group with all texts sent together was associated with an odds ratio of 0.67 (P=.01). Notably, previous cesarean section evoked an odds ratio of 11.78 (P<.001), highlighting that having a cesarean section predicts future cesarean section in a subsequent pregnancy. Conclusions: Sending pregnant women in rural China short informational messages with integrated advice regarding both care-seeking and good home prenatal practices appears to reduce women’s likelihood of undergoing cesarean section. Reducing clear medical indications for cesarean section seems to be the strongest potential pathway of the effect. Cesarean section based on only maternal request did not seem to occur regularly in our study population. Preventing unnecessary cesarean section at present may have a long-term impact on future cesarean section rates. Trial Registration: ClinicalTrials.gov NCT02037087; https://clinicaltrials.gov/ct2/show/NCT02037087. International Registered Report Identifier (IRRID): RR2-10.1136/bmjopen-2015-011016 SN - 2291-5222 UR - https://mhealth.www.mybigtv.com/2020/11/e19953 UR - https://doi.org/10.2196/19953 UR - http://www.ncbi.nlm.nih.gov/pubmed/33141099 DO - 10.2196/19953 ID - info:doi/10.2196/19953 ER -