Abstract: Objective To explore the risk factors of first cesarean section and the impact of risk correction on first cesarean section rate. Methods A total of 705 women with cesarean section admitted to the hospital from January 2021 to December 2022 were selected as study subjects， and all potential factors affecting first cesarean section were recorded. Regression analysis was used to screen out risk factors and protective factors， and a logistic equation was established to test its accuracy. The actual cesarean section rate and risk-adjusted cesarean section rate were compared. Results The risk factors of cesarean section mainly included age of delivery， body mass index， gravidity， gestational weeks， multiple pregnancies， pregnancy comorbidities and complications， intrapartum complications， education level， occupation， and assisted reproductive technology （P<0.05）. Preterm delivery and multipara were protective factors for the rate of first cesarean section. In addition， the risk-adjusted first cesarean section rates from January to December 2021 and from January to December 2022 were significantly lower than the actual first cesarean section rates， with statistical significance （P>0.05）. The results of specificity test of regression equation of first cesarean section rate showed that the area under the curve （AUC） of receiver operating characteristic （ROC） was 0.763， the standard deviation was 0.033 （P<0.001）， and the 95%CI was 0.699-0.827. The actual rates of first cesarean section from January to August 2021， from September 2021 to April 2022， and from May to December 2022 were higher than the risk-adjusted rates （P<0.05）. Conclusion Delivery age， body mass index， gravidity， gestational weeks， multiple pregnancies， pregnancy comorbidities and complications， intrapartum complications， education level， occupation， assisted reproductive technology， fetal condition， and maternal birth canal， and psychological status are all risk factors for first cesarean section rate. Risk-adjusted first cesarean section rate provides favorable conditions for obstetrics to reduce cesarean section rate， and is a key indicator for evaluating obstetric quality.

Key words: Risk factor for first cesarean section, Risk correction, First cesarean section rate