Odlind Viveca, Haglund Bengt, Pakkanen Milla, Otterblad Olausson Petra
Center for Epidemiology, Swedish National Board of Health and Welfare, Stockholm, Sweden.
Acta Obstet Gynecol Scand. 2003 Jun;82(6):516-28.
The aim of this report is to present descriptive data from the Swedish Medical Birth Register (MBR) reflecting trends in obstetric and neonatal practices over three decades.
Since 1973 the MBR at the Swedish National Board of Health and Welfare receives information on all pregnancies in Sweden--around 95,000 annually--that have lead to delivery regarding the pregnancy, delivery and the newborn infant. In this study selected data from the MBR are presented as they have developed between 1973 and 2000.
There was a shift in age distribution of childbearing women towards older women. Cigarette smoking in early pregnancy decreased from 30% to 12%. In-hospital time after both vaginal and cesarean (CS) delivery decreased and more than 50% of all women with a vaginal singleton delivery left hospital within 48 hours in 2000. The proportion of CS increased from 5 to 15% at singleton deliveries. The CS rate for breech deliveries increased and was nearly 80% in 2000. The mean birth weight increased, particularly the proportion of heavy infants. The proportion of early neonatal deaths decreased continuously, both for term infants and infants born after short gestational length, whereas no such downward trends was found for stillbirth during the last 10-15 years.
Although several of the changes regarding pregnancy and delivery that occurred between 1973 and 2000 could be expected to influence pregnancy outcome negatively, the trends described here generally suggest improvement in maternal and child health.
本报告旨在展示来自瑞典医学出生登记处(MBR)的描述性数据,以反映三十年来产科和新生儿医疗实践的趋势。
自1973年以来,瑞典国家卫生和福利委员会的MBR接收了瑞典所有怀孕情况的信息——每年约95000例——这些怀孕均已分娩,涉及妊娠、分娩及新生儿情况。在本研究中,呈现了MBR在1973年至2000年间的数据变化情况。
生育女性的年龄分布向高龄女性偏移。孕早期吸烟率从30%降至12%。阴道分娩和剖宫产术后的住院时间均缩短,2000年,超过50%的单胎阴道分娩女性在48小时内出院。单胎分娩的剖宫产率从5%增至15%。臀位分娩的剖宫产率上升,2000年接近80%。平均出生体重增加,尤其是超重婴儿的比例。早期新生儿死亡率持续下降,足月婴儿和孕周较短出生的婴儿均如此,而在过去10 - 15年中,死产率未呈现下降趋势。
尽管1973年至2000年间发生的一些妊娠和分娩方面的变化可能会对妊娠结局产生负面影响,但此处描述的趋势总体上表明母婴健康状况有所改善。