Maouris P, Jennings B, Ford J, Karczub A, Kohan R, Butt J, Evans S, Gee V
King Edward Memorial Hospital, 374 Bagot Road, Subiaco, WA 6008, Australia.
J Obstet Gynaecol. 2010 Jan;30(1):6-9. doi: 10.3109/01443610903276409.
The objective of this study was to determine the effect of a multi-professional outreach obstetric training programme on perinatal and neonatal outcomes. This was a retrospective comparison of 5-min low Apgar scores, stillbirth, perinatal death and moderate/severe hypoxic ischaemic encephalopathy rates in 127,753 infants born in Western Australia before and after the introduction of training in rural and remote areas. Following the introduction of the training programme, there was a highly significant (p = 0.003) decrease in the rate of infants born with low 5-min Apgar scores (from 20.4 to 15.4/1,000 live births). While the changes in the other three outcomes were not significant, all three demonstrated a trend for improvement in the intervention area. This is the second study of an educational intervention in obstetrics to demonstrate improvement in neonatal outcome and the first to be associated with a decrease in caesarean sections.
本研究的目的是确定多专业外展产科培训计划对围产期和新生儿结局的影响。这是一项回顾性比较研究，比较了西澳大利亚州农村和偏远地区引入培训前后出生的127,753名婴儿的5分钟低Apgar评分、死产、围产期死亡以及中度/重度缺氧缺血性脑病发生率。引入培训计划后，5分钟Apgar评分低的婴儿出生率显著下降（p = 0.003）（从每1000例活产中的20.4例降至15.4例）。虽然其他三个结局的变化不显著，但在干预地区这三个结局均呈现改善趋势。这是第二项证明产科教育干预可改善新生儿结局的研究，也是第一项与剖宫产率下降相关的研究。
