目的：通过对北京市海淀区和朝阳区两区所有提供助产服务的各级医疗保健机构上报信息的汇总，分析调整生育政策对北京市产科资源的影响。方法2014—2015年选择北京市人口及助产机构数量居前两位的海淀区和朝阳区内所有提供助产服务的各级医疗保健机构44家，提取其上报到首都医科大学附属北京妇产医院群体信息科的综合信息，观察2013—2015年每季度所有孕妇建册量、产科活产数，每年度产科活产数、床位数、每张床位承接活产数、日门诊量、床位使用率、高龄产妇所占比例、高危产妇所占比例，高危产妇中妊娠期糖尿病所占比例、瘢痕子宫所占比例。结果2014年符合“单独二孩”政策再生育孕妇建册量占所有孕妇建册量的12.2％~15.3％，2015年为5.7％~9.3％。2014—2015年符合“单独二孩”政策的第二胎的活产数占2014—2015年产科总活产数的10.6％。朝阳区和海淀区44家助产机构中，2013年产科活产数86938例，床位数1567张，每张床位承接活产数55例；2014年产科活产数112854例，床位数1867张，每张床位承接活产数60例；2015年产科活产数74495例，床位数1881张，每张床位承接活产数40例；2014年产科每张床位承接活产数较2013年上升了9.1％，2015年较2013年下降了27.3％、较2014年下降了33.3％。2013年产科日门诊量4928人次，2014年为5746人次，2015年为5214人次；2014年产科日门诊量较2013年上升了16.6％，2015年较2013年上升了5.8％、较2014年下降了9.3％。2013年产科床位使用率为86.5％，2014年为91.5％，2015年为71.9％。2014年、2015年高龄产妇、高危产妇所占比例均高于2013年（P ﹤0.05）；2015年高龄产妇、高危产妇所占比例均低于2014年（P ﹤0.05）。2014年、2015年高危产妇中妊娠期糖尿病、瘢痕子宫产妇所占比例均高于2013年（P ﹤0.05）；2015年高危产妇中妊娠期糖尿病、瘢痕子宫产妇所占比例均低于2014年（P ﹤0.05）。结论随着生育政策的调整短时间内出现了生育高峰，相应助产机构每张床位承接活产数上升，门诊量上升，而高危产妇也大幅度增加，导致产科压力增大，因此及时建立完善优质的妇幼保健服务体系非常必要。%Objective To analyze the impacts of adjusting birth policy on Beijing obstetrics resources through summarizing the data reported by all the health care institutions at various levels that provide maternal health services in Haidian and Chaoyang districts in Beijing. Methods 44 health care institutions at various levels that provided maternal health services were selected from Haidian and Chaoyang districts due to their top two quantities in population and delivery institutions from 2014 to 2015. We extracted the comprehensive information reported to the Department of Information and Statistics of Beijing Obstetrics and Gynecology Hospital,Capital Medical University by these health care institutions,and observed the quarterly number of maternal registrations and of live births in obstetrics,the annual number of live births and obstetrics beds,undertaking number of live births per bed,daily outpatient visits,bed occupancy rate,the proportion of older mothers,the proportion of pregnant women with high risk,the proportion of high risk pregnant women with gestational diabetes and the proportion of high risk pregnant women with uterine scar of the year 2013 to 2015. Results The maternal registrations proportion of those who had met the policy that only - child parents could have a second child and had already had a second child in the total number of maternal registrations was 12. 2% ~ 15. 3% in 2014,and in 2015 was 5. 7% ~ 9. 3% . The number of second child live birth in 2014 to 2015 of those who met the policy that only - child parents could have a second child covered 10. 6% of total live birth numbers in obstetrics in 2014 to 2015. Among the 44 delivery institutions in Chaoyang and Haidian districts,the number of live births in obstetrics was 86 938,1 567 obstetrics beds with the undertaking number of 55 cases per bed in 2013;in 2014 the above three numbers were 112 854,1 867 and 60 separately;and in 2015,the numbers were 74 495,1 881 and 40 respectively. Compared with the undertaking number of live births per bed in obstetrics in 2013,the number in 2014 increased by 9. 1% ,and decreased by 27. 3% in 2015. Compared with 2014,the undertaking number of live births per bed in obstetrics in 2015 was decreased by 33. 3%. The daily outpatient visits in obstetrics of 2013,2014 and 2015 was 4 928,5 746 and 5 214 respectively;Compared with the daily outpatient visits in obstetrics in 2013,the number in 2014 increased by 16. 6% and in 2015 increased by 5. 8%. Compared with the daily outpatient visits in obstetrics in 2014,the number in 2015 decreased by 9. 3% . The rate of obstetrics beds usage in obstetrics was 86. 5% in 2013,91. 5% in 2014 and 71. 9% in 2015. The proportions of older mothers and pregnant women with high risks in 2014 and 2015 were higher than those in 2013( P ﹤ 0. 05);the proportions of older mothers and pregnant women with high risks in 2015 were lower than those in 2014(P ﹤ 0. 05). The proportions of high risk pregnant women with gestational diabetes and uterine scar in 2014 and 2015 were higher than those in 2013(P ﹤ 0. 05). The proportions of high risk pregnant women with gestational diabetes and uterine scar in 2015 were lower than those in 2014(P ﹤0. 05). Conclusion The birth policy adjustment leads to a short - time baby boom,which increases the number of live births undertaking and outpatient visits of the corresponding delivery institutions. Moreover,the dramatically increasing number of pregnant women with high risk generates growing pressures in obstetrics. Therefore,it is necessary to timely establish a perfect and superior maternal and child health service system.
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