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择期剖宫产术超过 37 孕周分娩的新生儿结局:全国登记处的 7 年回顾性分析。

Neonatal outcome following elective cesarean section beyond 37 weeks of gestation: a 7-year retrospective analysis of a national registry.

机构信息

Department of Obstetrics and Gynecology, Sint Franciscus Gasthuis, Rotterdam, The Netherlands.

出版信息

Am J Obstet Gynecol. 2010 Mar;202(3):250.e1-8. doi: 10.1016/j.ajog.2010.01.052.

Abstract

OBJECTIVE

We sought to evaluate number and timing of elective cesarean sections at term and to assess perinatal outcome associated with this timing.

STUDY DESIGN

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.

RESULTS

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.

CONCLUSION

More than 50% of the elective cesarean sections are applied at <39 weeks, thus jeopardizing neonatal outcome.

摘要

目的

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。

研究设计

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。

结果

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)。

结论

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。

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