Weintraub Adi Y, Levy Amalia, Holcberg Gershon, Sheiner Eyal
Department of Obstetrics and Gynecology, Faculty of Health Sciences, Soroka University Medical Center, Ben-Gurion University of the Negev Beer-Sheva, Israel.
Int J Fertil Womens Med. 2006 Nov-Dec;51(6):275-9.
The purpose of this study was to examine the outcome of pregnancies in women suffering blunt abdominal trauma, which preceded birth.
A retrospective cohort study was performed comparing patients who did and did not suffer blunt abdominal trauma preceding birth. Deliveries occurred during the years 1988-2002 in a tertiary medical center. Data regarding abdominal trauma that led to birth was available from the perinatal database of the center. Stratified analysis, using a multiple logistic regression model, was performed to control for confounders.
Fifty-four cases of blunt abdominal trauma leading to birth were identified out of 159,223 deliveries that occurred during the study period. Using a multivariate analysis, with backward elimination, placental abruption (OR = 10.0; 95% CI 3.9-25.5; P < 0.001) and preterm delivery (OR = 2.5; 95% CI 1.3-5.0; P = 0.008) were found to be significantly associated with blunt abdominal trauma. A higher rate of Cesarean deliveries was noted among women suffering abdominal trauma (24.1% vs. 12.2%, P = 0.019). No significant differences were found regarding the perinatal outcome between women who did and did not suffer abdominal trauma, as demonstrated by an Apgar score of less than seven at one (7.4% vs. 4.5%, P = 0.30) and five minutes (1.9% vs. 0.6%, P = 0.28) and by perinatal mortality rates (3.7% vs. 1.5%, P = 0.19).
Blunt abdominal trauma was significantly associated with placental abruption and preterm delivery. However, the perinatal outcome of these pregnancies was not significantly different from that of the general population.
本研究旨在探讨分娩前遭受钝性腹部创伤的女性的妊娠结局。
进行一项回顾性队列研究，比较分娩前遭受和未遭受钝性腹部创伤的患者。1988年至2002年期间在一家三级医疗中心进行分娩。该中心围产期数据库提供了导致分娩的腹部创伤相关数据。采用多元逻辑回归模型进行分层分析，以控制混杂因素。
在研究期间发生的159,223例分娩中，确定了54例因钝性腹部创伤导致分娩的病例。通过多变量分析及向后逐步淘汰法，发现胎盘早剥（比值比[OR]=10.0；95%可信区间[CI] 3.9 - 25.5；P<0.001）和早产（OR = 2.5；95% CI 1.3 - 5.0；P = 0.008）与钝性腹部创伤显著相关。腹部创伤女性的剖宫产率较高（24.1%对12.2%，P = 0.019）。在1分钟（7.4%对4.5%，P = 0.30）和5分钟（1.9%对0.6%，P = 0.28）时阿氏评分低于7分以及围产期死亡率方面（3.7%对1.5%，P = 0.19），遭受和未遭受腹部创伤的女性围产期结局无显著差异。
钝性腹部创伤与胎盘早剥和早产显著相关。然而，这些妊娠的围产期结局与一般人群并无显著差异。
