Abstract: Objective To explore the status and indication changes for cesarean section in medical institutions in Huainan region,in order to provide empirical evidence for the formulation of scientific intervention measures and management strategies. Methods Women who gave birth in Huainan Maternal and Child Health Hospital,Huainan First People's Hospital,and Huainan Dongfang Hospital from January 2019 to December 2022 were selected as the survey objects. General demographic information and pregnancy-related information were collected. Indicators for cesarean section were evaluated according to Expert Consensus on Cesarean Section Operation （2014）. Descriptive analysis was used to analyze the status of cesarean section and the change of indications,and univariate and multivariate analyses were used to analyze the related factors of cesarean section without medical indications. Results A total of 10 878 cases of maternal data were collected,including 3 750 cases of cesarean section,accounting for 34.47%. The cesarean section rates from 2019 to 2022 showed a gradually decreasing trend （trend χ²=160.049,P<0.01）,and were 45.63%,39.31%,31.85%,and 23.63%,respectively. There was significant difference in the distribution of indications of cesarean section from 2019 to 2022 （χ²=340.037,P<0.01）,among which scar uterus accounted for the highest proportion. From 2019 to 2022,the proportion of scar uterus and fetal distress in the indications of cesarean section showed a gradually increasing trend,while the proportion of placental abruption and placenta previa showed a gradually decreasing trend. Among the 3 750 women who gave cesarean section,166 had cesarean section without medical indications,accounting for 4.43%. The main reason for cesarean section without medical indications was the fear of not being able to deliver naturally,and after the trial delivery,a cesarean section must be changed （32.53%）. The results of multivariate Logistic regression analysis showed that the rate of cesarean section without medical indications was higher in women aged 30-35 （OR=1.093） and 35-40 （OR=1.097）,with a pre pregnancy BMI of≥28.0 kg/m² （OR=2.933）,multiparous women （OR=1.664）,those who were unaware of pregnancy and childbirth related knowledge （OR=1.670）,and those who had prenatal anxiety （OR=4.865）. Conclusions From 2019 to 2022,the cesarean section rate in medical institutions in Huainan region shows a decreasing trend. The highest proportion of cesarean section indications is scar uterus,and there are still a certain proportion of cesarean section without indications.

Key words: Cesarean section, Cesarean section without medical indications, Scar uterus, Fetal distress, Influencing factor