剖宫产史的女性足月臀位产的发生率是否更高？

Is a breech presentation at term more frequent in women with a history of cesarean delivery?

作者信息

Vendittelli Françoise, Rivière Olivier, Crenn-Hébert Catherine, Rozan Marc-Alain, Maria Bernard, Jacquetin Bernard

机构信息

Association des Utilisateurs de Dossiers Informatisés en Pédiatrie, Obstétrique et Gynécologie sentinel network, Lyon, France.

出版信息

Am J Obstet Gynecol. 2008 May;198(5):521.e1-6. doi: 10.1016/j.ajog.2007.11.009. Epub 2008 Feb 1.

DOI:10.1016/j.ajog.2007.11.009

PMID:18241817

Abstract

OBJECTIVE

The purpose of this study was to determine whether breech presentation at term is more common among women with at least 1 previous cesarean delivery.

STUDY DESIGN

This historic cohort study (n = 84,688) included women with a singleton term pregnancy and at least 1 previous delivery. Results were expressed as crude relative risks and adjusted odds ratios.

RESULTS

While 2.46% of women had a fetus in breech presentation at term, 14.91% of women had had 1 or more previous cesareans. The relative risk of a breech presentation at term for women with a history of cesarean was 2.18 (95%CI: 1.98-2.39). It did not differ according to the number of previous cesareans. The logistic regression analysis took into account confounding factors including gestational age, maternal age, parity, birthweight, and oligohydramnios. The adjusted odds ratio was 2.12 (95%CI: 1.91-2.36).

CONCLUSION

Women with previous cesarean deliveries have a risk of breech presentation at term twice that of women with previous vaginal deliveries.

摘要

目的

本研究旨在确定既往至少有一次剖宫产史的女性足月臀先露是否更为常见。

研究设计

这项历史性队列研究（n = 84,688）纳入了单胎足月妊娠且既往至少有一次分娩史的女性。结果以粗相对风险和调整后的比值比表示。

结果

虽然2.46%的女性足月时胎儿为臀先露，但14.91%的女性既往有一次或多次剖宫产史。有剖宫产史的女性足月臀先露的相对风险为2.18（95%CI：1.98 - 2.39）。该风险并不因既往剖宫产次数而有所不同。逻辑回归分析考虑了包括孕周、产妇年龄、产次、出生体重和羊水过少等混杂因素。调整后的比值比为2.12（95%CI：1.91 - 2.36）。