首次剖宫产术后再次妊娠发生不明原因产前死胎的风险。
The risk of unexplained antepartum stillbirth in second pregnancies following caesarean section in the first pregnancy.
作者信息
Wood S L, Chen S, Ross S, Sauve R
机构信息
Department of Obstetrics and Gynecology, University of Calgary, Foothills Hospital, Calgary, Alberta, Canada.
出版信息
BJOG. 2008 May;115(6):726-31. doi: 10.1111/j.1471-0528.2008.01705.x.
OBJECTIVE
To determine if a previous caesarean section increases the risk of unexplained antepartum stillbirth in second pregnancies.
STUDY DESIGN
Retrospective cohort study.
SETTING
Large Canadian perinatal database.
POPULATION
158 502 second births.
METHODS
Data were obtained from a large perinatal database, which supplied data on demographics, pregnancy complications, maternal medical conditions, previous caesarean section and pregnancy outcomes.
MAIN OUTCOME MEASURES
Total and unexplained stillbirth.
RESULTS
The antepartum stillbirth rate was 3.0/1000 in the previous caesarean section group compared with 2.7/1000 in the previous vaginal delivery group (P= 0.46). Multivariate logistic regression modelling, including terms for maternal age (polynomial), weight >91 kg, smoking during pregnancy, pre-pregnancy hypertension and diabetes, did not document an association between previous caesarean section and unexplained antepartum stillbirth (OR 1.27, 95% CI 0.92-1.77).
CONCLUSION
Caesarean section in the first birth does not increase the risk of unexplained antepartum stillbirth in second pregnancies.
目的
确定既往剖宫产是否会增加第二次妊娠时不明原因的产前死胎风险。
研究设计
回顾性队列研究。
研究地点
加拿大大型围产期数据库。
研究对象
158502例第二次分娩。
方法
数据来源于一个大型围产期数据库，该数据库提供了人口统计学、妊娠并发症、母亲健康状况、既往剖宫产情况及妊娠结局等数据。
主要观察指标
总死胎率和不明原因死胎率。
结果
既往剖宫产组的产前死胎率为3.0/1000，而既往阴道分娩组为2.7/1000（P = 0.46）。多因素logistic回归模型，纳入了母亲年龄（多项式）、体重>91 kg、孕期吸烟、孕前高血压和糖尿病等因素，未发现既往剖宫产与不明原因产前死胎之间存在关联（比值比1.27，95%可信区间0.92 - 1.77）。
结论
首次分娩时的剖宫产不会增加第二次妊娠时不明原因产前死胎的风险。
Zotero 插件