目標：現今我國產科照護之主要議題為外籍產婦的不斷增加及過高的剖腹產率。剖腹產率過高可能潛存醫療資源浪費，而偏低則暗示著醫療照護不足。本研究係調查分析不同國籍產婦在周產期之相關背景及其生產方式的差異情形，以作為產科醫師及衛生醫療主管機關的參考。方法：以準結構式問卷及病歷資料分析，抽樣對象為一生產數多且配合研究之中部某區域教學醫院及某大型婦產科專科診所，對所有不同國籍產婦共1465位進行調查。以卡方檢定、變異數分析及羅吉斯迴歸分析，探討其背景資料之差異與不同族群婦女選用生產方式之影響因素。結果：本國籍、大陸籍與東南亞籍婦女之剖腹產率各為33.6%、26.3%及17.9%，呈現明顯差異。本國籍產婦之年齡、體重、剖腹產次數均較外籍產婦為高，而社經背景也較好。後續分析顯示本國籍產婦之年齡、體重等生理因素則是造成剖腹率偏高的主因，而國籍別則非影響不同國籍婦女剖腹產率差異的主要因素。結論：我國產婦及醫師在決定採用剖腹產時受國籍別等非醫療因素干擾不大。因此，研擬降低剖腹產率偏高的有效策略應自醫療因素著手。
Objectives: In Taiwan, the increase of foreign-born mothers and the high prevalence of Cesarean rate are major issues in obstetric medical care. A high Cesarean rate may imply the waste of medical resources, while a low Cesarean rate may indicate the lack of medical care. The aim of the research is to describe and explain the differences between native and foreign-born mothers. Methods: Using semi-structured questionnaires and medical chart review, information was collected from 1465 mothers from one negional hospital and one clinicin central Taiwan for livebirths in 2005. We used Chi-square test, analysis of variance, and logistic regression to determine the factors that affect the choice of delivery mode. Results: Newborns arrived by Cesarean delivery in 397 of 1182 (33.6%) of Taiwanese mothers, 20 of 76 (26.3%) of mainland China mothers, and 37 of 207 (17.9%) of Southeast Asia mothers. Taiwanese mothers had statistically significantly higher age, maternal body weight, and socioeconomic status than other mothers. Further analysis revealed that nationality is not the direct influential factor, instead physiological factors such as age and maternal body weight are more significant. Conclusion: When mothers and obstetricians make medical decisions, non-medical factors such as ethnicity may not directly influence the selection of delivery mode. Accordingly, clinical and physiological factors should be included in the design of effective strategies for reducing cesarean rate in Taiwan.
