Department of Obstetrics and Gynecology, Sint Franciscus Gasthuis, Rotterdam, The Netherlands.
Am J Obstet Gynecol. 2010 Mar;202(3):250.e1-8. doi: 10.1016/j.ajog.2010.01.052.
We sought to evaluate number and timing of elective cesarean sections at term and to assess perinatal outcome associated with this timing.
We conducted a recent retrospective cohort study including all elective cesarean sections of singleton pregnancies at term (n = 20,973) with neonatal follow-up. Primary outcome was defined as a composite of neonatal mortality and morbidity.
More than half of the neonates were born at <39 weeks of gestation, and they were at significantly higher risk for the composite primary outcome than neonates born thereafter. The absolute risks were 20.6% and 12.5% for birth at <38 and 39 weeks, respectively, as compared to 9.5% for neonates born > or = 39 weeks. The corresponding adjusted odds ratios (95% confidence interval) were 2.4 (2.1-2.8) and 1.4 (1.2-1.5), respectively.
More than 50% of the elective cesarean sections are applied at <39 weeks, thus jeopardizing neonatal outcome.
我们旨在评估足月时选择性剖宫产的数量和时间，并评估与这种时间相关的围产儿结局。
我们进行了一项最近的回顾性队列研究，纳入了所有足月单胎妊娠的选择性剖宫产（n=20973）并进行新生儿随访。主要结局定义为新生儿死亡和发病率的复合结局。
超过一半的新生儿在<39 周时出生，与此后出生的新生儿相比，他们发生主要复合结局的风险显著更高。出生于<38 周和 39 周的新生儿的绝对风险分别为 20.6%和 12.5%，而出生于>或=39 周的新生儿的相应调整后比值比（95%置信区间）分别为 2.4（2.1-2.8）和 1.4（1.2-1.5）。
超过 50%的选择性剖宫产在<39 周时进行，从而危及新生儿结局。
