足月多胎妊娠的风险主动管理：较高的预防性引产率与改善分娩结局之间的关联。
The active management of risk in multiparous pregnancy at term: association between a higher preventive labor induction rate and improved birth outcomes.
作者信息
Nicholson James M, Caughey Aaron B, Stenson Morghan H, Cronholm Peter, Kellar Lisa, Bennett Ian, Margo Katie, Stratton Joseph
机构信息
Department of Family Medicine and Community Health, University of Pennsylvania School of Medicine, Philadelphia, PA, USA.
出版信息
Am J Obstet Gynecol. 2009 Mar;200(3):250.e1-250.e13. doi: 10.1016/j.ajog.2008.08.053.
OBJECTIVE
To determine whether exposure of multiparous women to a high rate of preventive labor induction was associated with a significantly lower cesarean delivery rate.
STUDY DESIGN
Retrospective cohort study involving 123 multiparous women, who were exposed to the frequent use of preventive labor induction, and 304 multiparous women, who received standard management. Rates of cesarean delivery and other adverse birth outcomes were compared in the 2 groups. Logistic regression controlled for confounding covariates.
RESULTS
The exposed group had a lower cesarean delivery rate (adjusted odds ratio, 0.09; 0.8% vs 9.9%; P = .02) and a higher uncomplicated vaginal delivery rate (odds ratio, 0.53; 78.9% vs 66.4%; P = .01). Exposure was not associated with higher rates of other adverse birth outcomes.
CONCLUSION
Exposure of multiparous women to a high rate of preventive labor induction was significantly associated with improved birth outcomes, including a very low cesarean delivery rate. A prospective randomized trial is needed to determine causality.
目的
确定经产妇接受高频率预防性引产是否与剖宫产率显著降低相关。
研究设计
回顾性队列研究，纳入123名经常接受预防性引产的经产妇和304名接受标准管理的经产妇。比较两组的剖宫产率及其他不良分娩结局。采用逻辑回归分析控制混杂协变量。
结果
暴露组剖宫产率较低（校正比值比为0.09；0.8%对9.9%；P = 0.02），无并发症的阴道分娩率较高（比值比为0.53；78.9%对66.4%；P = 0.01）。暴露与其他不良分娩结局的较高发生率无关。
结论
经产妇接受高频率预防性引产与改善分娩结局显著相关，包括极低的剖宫产率。需要进行前瞻性随机试验以确定因果关系。
Zotero 插件