Gerten Kim A, Coonrod Dean V, Bay R Curtis, Chambliss Linda R
Department of Obstetrics, Gynecology & Women's Health, Maricopa Integrated Health System, MedPro, Phoeniz, AZ, USA.
Am J Obstet Gynecol. 2005 Sep;193(3 Pt 2):1061-4. doi: 10.1016/j.ajog.2005.05.038.
The purpose of this study was to determine if cesarean delivery is a risk factor for respiratory distress syndrome (RDS) and if this risk is modified by labor before cesarean.
This population-based case-control study compared 4778 cases of RDS to 5 times as many controls.
Unadjusted, cesarean delivery was associated with RDS, odds ratio (OR) 3.5 (95% CI 3.2-3.8). After controlling for potential confounding variables, cesarean remained an independent risk factor, OR 2.3 (95% CI 2.1-2.6). Labor modified this risk significantly (P = .02)--with labor, cesarean delivery had an OR of 1.9 (95% CI 2.2-2.9), without labor, the OR was 2.6 (95% CI 1.3-2.8).
Cesarean delivery was an independent risk factor for RDS. The risk was reduced with labor before cesarean, but still elevated. This supports the importance of being certain of fetal lung maturity before cesarean delivery, particularly when done before labor.
本研究旨在确定剖宫产是否为呼吸窘迫综合征（RDS）的危险因素，以及剖宫产之前的分娩是否会改变这一风险。
这项基于人群的病例对照研究将4778例RDS病例与5倍数量的对照进行了比较。
未经调整时，剖宫产与RDS相关，比值比（OR）为3.5（95%可信区间[CI] 3.2 - 3.8）。在控制了潜在的混杂变量后，剖宫产仍然是一个独立的危险因素，OR为2.3（95% CI 2.1 - 2.6）。分娩显著改变了这一风险（P = 0.02）——有分娩时，剖宫产的OR为1.9（95% CI 2.2 - 2.9），无分娩时，OR为2.6（95% CI 1.3 - 2.8）。
剖宫产是RDS的一个独立危险因素。剖宫产之前有分娩时风险降低，但仍有所升高。这支持了在剖宫产之前确定胎儿肺成熟度的重要性，尤其是在分娩前进行剖宫产时。
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