Nikkol E M, Kirjavainen T T, Ekblad U U, Kero P O, Salonen M A O
Department of Anesthesiology, Turku University Hospital, Finland.
Acta Paediatr. 2002;91(9):927-33. doi: 10.1080/080352502760272605.
To compare postnatal adaptation between Caesarean and vaginal deliveries, by studying sleep states, oxygenation, heart rate and body movements. Another aim was to follow the adaptation of healthy, term, vaginally born babies.
Ten vaginally born and 12 neonates born by elective Caesarean section were recorded with a movement sensor (SCSB, static-charge-sensitive bed), electrocardiogram and oximeter. The recordings started 1.5 h after birth and lasted for 12 h. For the vaginal group, another 12 h recording was performed during the third night postpartum.
Delivery mode did not affect sleep state distribution. The vaginal group had more oxyhaemoglobin desaturation episodes <95% than the Caesarean section group (mean +/- SD: 59 +/- 10% vs 42 +/- 22% of epochs, p = 0.03), especially in active sleep, but baseline saturation was similar (96 +/- 1% vs 95 +/- 3%, p = 0.93). The vaginal group had fewer movements during sleep than the Caesarean section group (movements of 5-10 s: 5 +/- 1 h(-1) vs 10 +/- 3 h(-1), p = 0.0001). During the first 3 d, the amount of sleeping and active sleep increased, whereas wakefulness and quiet sleep decreased. Baseline oxyhaemoglobin saturation and the number of movements of over 5 s increased.
Delivery mode did not affect sleep state distribution but, unexpectedly, the vaginal group had more oxyhaemoglobin desaturation events and fewer body movements than the Caesarean section group. These differences during the first postnatal day remain unexplained, but they may reflect stress and pain during labour. After a few days, changes in sleep organization, and increases in oxyhaemoglobin saturation and frequency of body movements were noted in the vaginal group, which may represent recovery and adaptation to extrauterine life.
通过研究睡眠状态、氧合作用、心率和身体活动，比较剖宫产和阴道分娩后的新生儿适应情况。另一个目的是追踪健康足月儿阴道分娩后的适应情况。
使用运动传感器（SCSB，静电荷敏感床）、心电图仪和血氧饱和度测定仪对10例阴道分娩的新生儿和12例择期剖宫产的新生儿进行记录。记录在出生后1.5小时开始，持续12小时。对于阴道分娩组，在产后第三天晚上再进行12小时的记录。
分娩方式不影响睡眠状态分布。阴道分娩组氧合血红蛋白饱和度<95%的发作次数比剖宫产组多（平均值±标准差：各时段分别为59±10%和42±22%，p = 0.03），尤其是在主动睡眠时，但基线饱和度相似（96±1%和95±3%，p = 0.93）。阴道分娩组睡眠期间的活动比剖宫产组少（持续5 - 10秒的活动：5±1次/小时 vs 10±3次/小时，p = 0.0001）。在出生后的前3天，睡眠时间和主动睡眠时间增加，而清醒时间和安静睡眠时间减少。基线氧合血红蛋白饱和度和持续超过5秒的活动次数增加。
分娩方式不影响睡眠状态分布，但出乎意料的是，阴道分娩组的氧合血红蛋白去饱和事件比剖宫产组多，身体活动比剖宫产组少。出生后第一天出现的这些差异尚无法解释，但可能反映了分娩过程中的压力和疼痛。几天后，阴道分娩组出现睡眠结构变化，氧合血红蛋白饱和度和身体活动频率增加，这可能代表着对宫外生活的恢复和适应。
