首次分娩剖宫产与第二次分娩时胎盘早剥或前置胎盘(1)。

First-birth cesarean and placental abruption or previa at second birth(1).

作者信息

Lydon-Rochelle M, Holt V L, Easterling T R, Martin D P

机构信息

Department of Health Services, School of Public Health and Community Medicine, University of Washington, Seattle, Washington, USA.

出版信息

Obstet Gynecol. 2001 May;97(5 Pt 1):765-9.

PMID:11339931

Abstract

OBJECTIVE

To assess the association between first-birth cesarean delivery and second-birth placental abruption and previa.

METHODS

We conducted a population-based, retrospective cohort analysis using data from the Washington State Birth Events Record Database. The study cohort included all primiparas who gave birth to live singleton infants in nonfederal short-stay hospitals from January 1, 1987, through December 31, 1996, and who had second singleton births during the same period (n = 96,975). Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated for placental abruption or previa at second births associated with first-birth cesareans.

RESULTS

Among our study cohort, abruptio placentae complicated 11.5 per 1000 and placenta previa 5.2 per 1000 singleton deliveries at second births. In logistic regression analyses adjusted for maternal age, women with first-birth cesareans had significantly increased risk of abruptio placentae (OR 1.3, 95% CI 1.1, 1.5), and placenta previa (OR 1.4, 95% CI 1.1, 1.6) at second births, compared with women with prior vaginal deliveries.

CONCLUSION

We found moderately increased risk of placental abruption and previa as a long-term effect of prior cesarean delivery on second births.

摘要

目的

评估首次分娩剖宫产与第二次分娩胎盘早剥及前置胎盘之间的关联。

方法

我们使用华盛顿州出生事件记录数据库的数据进行了一项基于人群的回顾性队列分析。研究队列包括1987年1月1日至1996年12月31日期间在非联邦短期住院医院分娩活产单胎婴儿且同期有第二次单胎分娩的所有初产妇（n = 96,975）。计算了与首次分娩剖宫产相关的第二次分娩时胎盘早剥或前置胎盘的比值比（OR）和95%置信区间（CI）。

结果

在我们的研究队列中，第二次分娩时胎盘早剥在每1000例单胎分娩中占11.5例，前置胎盘占5.2例。在对产妇年龄进行调整的逻辑回归分析中，与先前经阴道分娩的女性相比，首次分娩剖宫产的女性在第二次分娩时发生胎盘早剥（OR 1.3，95% CI 1.1，1.5）和前置胎盘（OR 1.4，95% CI 1.1，1.6）的风险显著增加。