@Article{info:doi/10.2196/19953，作者=“苏燕方和Heitner, Jesse和Yuan, Changzheng和Si，亚菲和Wang, Dan和Zhou, Zhiying和Zhou, Zhongliang”，标题=“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”，期刊=“JMIR Mhealth Uhealth”，年=“2020”，月=“11”，日=“3”，卷=“8”，数=“11”，页=“e19953”，关键词=“剖宫产;短消息服务;短信;准随机对照试验;，摘要=“背景:人们普遍认为，适当的地区剖宫产率不应超过新生儿的15%，但中国的剖宫产率在一些地区超过了50%，这促使人们呼吁降低剖宫产率。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。 Messages were delivered throughout pregnancy and were tailored to each woman's gestational week. The main outcome was the rates of cesarean delivery reported in the intervention arms. Data analysts were blinded to treatment assignment. 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 ", issn="2291-5222", doi="10.2196/19953", url="https://mhealth.www.mybigtv.com/2020/11/e19953", url="https://doi.org/10.2196/19953", url="http://www.ncbi.nlm.nih.gov/pubmed/33141099" }