分娩方式与新生儿产伤。

Route of delivery and neonatal birth trauma.

机构信息

Department of Gynecology and Obstetrics, Emory University, Atlanta, GA, USA.

出版信息

Am J Obstet Gynecol. 2010 Apr;202(4):361.e1-6. doi: 10.1016/j.ajog.2009.11.041. Epub 2010 Jan 15.

DOI:10.1016/j.ajog.2009.11.041

PMID:20079477

Abstract

OBJECTIVE

We sought to examine rates of birth trauma in 2 groupings (all International Classification of Diseases, Ninth Revision codes for birth trauma, and as defined by the Agency for Healthcare Research and Quality Patient Safety Indicator [PSI]) among infants born by vaginal and cesarean delivery.

STUDY DESIGN

Data on singleton infants were obtained from the 2004-2005 Healthcare Cost and Utilization Project Nationwide Inpatient Sample.

RESULTS

The rates of Agency for Healthcare Research and Quality PSI and all birth trauma were 2.45 and 25.85 per 1000 births, respectively. Compared with vaginal, cesarean delivery was associated with increased odds of PSI birth trauma (odds ratio [OR], 1.71), primarily due to an increased risk for "other specified birth trauma" (OR, 2.61). Conversely, cesarean delivery was associated with decreased odds of all birth trauma (OR, 0.55), due to decreased odds of clavicle fractures (OR, 0.07), brachial plexus (OR, 0.10), and scalp injuries (OR, 0.55).

CONCLUSION

Infants delivered by cesarean are at risk for different types of birth trauma from infants delivered vaginally.

摘要

目的

我们旨在检查阴道分娩和剖宫产分娩的婴儿中，按照（所有国际疾病分类，第九版的分娩创伤代码和医疗保健研究和质量患者安全指标[PSI]的定义）分组的分娩创伤发生率。

研究设计

来自 2004-2005 年医疗保健成本和利用项目全国住院患者样本的单胎婴儿数据。

结果

PSI 和所有分娩创伤的发生率分别为每 1000 例活产 2.45 例和 25.85 例。与阴道分娩相比，剖宫产分娩与 PSI 分娩创伤的几率增加相关（比值比[OR]，1.71），主要是由于“其他特定分娩创伤”的风险增加（OR，2.61）。相反，剖宫产分娩与所有分娩创伤的几率降低相关（OR，0.55），这是由于锁骨骨折（OR，0.07）、臂丛神经损伤（OR，0.10）和头皮损伤（OR，0.55）的几率降低所致。