Buchanan Sarah L, Patterson Jillian A, Roberts Christine L, Morris Jonathan M, Ford Jane B
Royal North Shore Hospital, University of Sydney, Sydney, NSW, Australia.
Aust N Z J Obstet Gynaecol. 2012 Apr;52(2):173-8. doi: 10.1111/j.1479-828X.2011.01403.x. Epub 2012 Mar 5.
To determine the trends in oxytocin use at a population level within New South Wales and to assess the maternal and neonatal morbidities associated with the use of oxytocin.
Trends in oxytocin use were assessed for women in NSW who were nulliparas at term with a singleton, cephalic fetus between 1998 and 2008. Maternal and neonatal morbidities were assessed in 2007-2008 using linked hospital and birth data with regression analysis. Oxytocin was also assessed by indication for use being either induction or augmentation of labour.
The overall use of oxytocin increased from 10,291 (36.5%) of births in 1998 to 14,440 (45.4%) of births in 2008 (P < 0.0001) with the increase entirely because of the increased use for induction of labour. The use of oxytocin was associated with an increase in regional analgesia (65 to 22%), instrumental delivery (21 to 18%) and caesarean section (29 to 14%) as compared to women who did not receive oxytocin in labour. Oxytocin was also associated with an increase in severe maternal adjusted odds ratios ((aOR) 1.48, 95% CI 1.30-1.68) and neonatal morbidity (aOR 1.29, 95% CI 1.17-1.41). This increase in morbidity was maintained when both augmentation and induction were assessed separately.
Oxytocin has an important role in the management of labour. However, its use should be carefully monitored with standardised treatment regimes to minimise maternal and neonatal morbidity.
确定新南威尔士州人群中缩宫素的使用趋势，并评估与缩宫素使用相关的孕产妇和新生儿发病率。
评估1998年至2008年间新南威尔士州足月单胎头位初产妇使用缩宫素的趋势。2007 - 2008年利用医院与出生数据的关联并通过回归分析评估孕产妇和新生儿发病率。缩宫素还根据引产或催产的使用指征进行评估。
缩宫素的总体使用量从1998年占分娩总数的10291例（36.5%）增至2008年的14440例（45.4%）（P < 0.0001），增加完全是因为引产使用量增加。与分娩时未接受缩宫素的女性相比，使用缩宫素与区域镇痛增加（从65%增至22%）、器械助产增加（从21%增至18%）及剖宫产增加（从29%增至14%）相关。缩宫素还与严重孕产妇调整比值比增加（调整比值比（aOR）1.48，95%可信区间1.30 - 1.68）和新生儿发病率增加（aOR 1.29，95%可信区间1.17 - 1.41）相关。当分别评估催产和引产时，发病率的这种增加依然存在。
缩宫素在分娩管理中具有重要作用。然而，应通过标准化治疗方案对其使用进行仔细监测，以尽量降低孕产妇和新生儿发病率。
