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在一个母亲相对身材较小的国家,身材矮小是头盆不称的独立危险因素。

Short stature as an independent risk factor for cephalopelvic disproportion in a country of relatively small-sized mothers.

机构信息

Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.

出版信息

Arch Gynecol Obstet. 2012 Jun;285(6):1513-6. doi: 10.1007/s00404-011-2168-3. Epub 2011 Dec 21.

Abstract

OBJECTIVE

To clarify the relationship between maternal height and cesarean rate due to cephalopelvic disproportion (CPD) in singleton pregnancies among ethnic groups of relatively short stature.

METHODS

A retrospective cohort study was performed on Thai singleton pregnancies at gestational age of more than 34 weeks. Logistic regression analysis was performed to correlate the maternal height and a risk for CPD. The short stature was defined by a cut-off value at 5th percentile ranking. Odds ratio for CPD was determined.

RESULTS

Of 11,026 recruited, 9,198 were available for analysis. Considering cut-off value of 145 cm, short stature was significantly associated with higher rate of CPD with odds ratio of 2.4 (95% CI 1.8-3.0). The odds = exp(4.048 - 0.042 × Ht). After control of other variables, the relationship between maternal height and rate of CPD was still high.

CONCLUSION

Mothers with short stature were significantly correlated with a higher rate of CPD, even after control of birth weight, parity and type of attendance. Clinical points could be drawn from this study including (1) definition of short statue must be developed for particular geographic or ethnic groups. In Thai population, using 145 cm as a cut-off value, odds of CPD is 2.4; (2) Probability of CPD may be estimated by maternal height as a single variable or multiple variables using logistic regression equations.

摘要

目的

厘清相对身材矮小的族群中,单胞胎妊娠因头盆不称(CPD)而行剖宫产的比例与产妇身高之间的关系。

方法

本研究为回顾性队列研究,纳入孕龄超过 34 周的泰国单胞胎妊娠。采用 logistic 回归分析,对产妇身高与 CPD 风险进行相关性分析。采用第 5 百分位的截断值定义矮小身材。计算 CPD 的比值比(OR)。

结果

共纳入 11026 例患者,其中 9198 例可用于分析。以 145cm 为截断值,矮小身材与 CPD 发生率较高显著相关,比值比(OR)为 2.4(95%CI 1.8-3.0)。OR=exp(4.048-0.042×Ht)。控制其他变量后,产妇身高与 CPD 发生率之间仍存在高度相关性。

结论

即使控制出生体重、产次和分娩方式等变量,身材矮小的产妇与 CPD 发生率较高显著相关。本研究的临床意义包括:(1)必须针对特定的地理或族群制定矮小身材的定义。在泰国人群中,采用 145cm 作为截断值,CPD 的 OR 为 2.4;(2)可通过产妇身高作为单一变量或使用 logistic 回归方程的多个变量来估计 CPD 的概率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/16d0/3351595/18d77463eb1f/404_2011_2168_Fig1_HTML.jpg

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