Friedler Jordana Mashiach, Mazor Moshe, Shoham-Vardi Ilana, Bashiri Asher
Department of Obstetrics and Gynecology, Faculty of Health Sciences, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer Sheva, Israel.
Harefuah. 2011 Nov;150(11):829-32, 877, 876.
To determine whether fetuses affected by either chromosomal abnormalities or central nervous system (CNS) malformations are prone to complications during pregnancy and delivery.
In this study, 320 singleton pregnancies with CNS malformations and 133 singleton pregnancies with chromosomal abnormaLities were compared with 149,112 singleton births without any known congenital anomalies. Exclusion criteria were: births with other congenital anomalies or malformations, pregnancies Lacking prenatal care and multiple pregnancies. Data was obtained using the computerized birth discharge records. The statistical analysis was performed with the SPSS package.
There were no statistically significant differences in maternal age, ethnicity, uterine anomalies or parity. The ratio of general anesthesia was almost double in the study groups compared to the control group: 25% in the CNS malformation group (RR 2.617, CI 2.031-3.372) and 25.6% in the chromosomal abnormality group (RR 2.696, CI 1.825-3.982) and 11.3% in the control group (p < 0.001). There were nearly double cesarean sections (CS) rates in both study groups: 21.5% in the CNS malformation group, 20.3% in the chromosomal abnormaLity group and 12% in the control group. A logistic regression model that included previous CS, maLpresentation, non-reassuring fetal heart monitor (NRFHR) and presence of a malformation, concluded that the presence of a malformation was not an independent risk factor for CS. However, indirect causes, such as malpresentation (4.34 OR), were independently associated with the malformations.
Fetuses affected by either CNS malformations or chromosomal abnormalities have a higher rate of pregnancy and delivery complications, including those which increase the risk of maternal morbidity and mortality.
确定受染色体异常或中枢神经系统（CNS）畸形影响的胎儿在妊娠和分娩期间是否易于出现并发症。
在本研究中，将320例患有CNS畸形的单胎妊娠和133例患有染色体异常的单胎妊娠与149,112例无任何已知先天性异常的单胎分娩进行比较。排除标准为：伴有其他先天性异常或畸形的分娩、缺乏产前护理的妊娠和多胎妊娠。数据通过计算机化的出生出院记录获得。使用SPSS软件包进行统计分析。
在产妇年龄、种族、子宫异常或产次方面无统计学显著差异。与对照组相比，研究组全身麻醉的比例几乎翻倍：CNS畸形组为25%（相对危险度2.617，可信区间2.031 - 3.372），染色体异常组为25.6%（相对危险度2.696，可信区间1.825 - 3.982），对照组为11.3%（p < 0.001）。两个研究组的剖宫产（CS）率几乎翻倍：CNS畸形组为21.5%，染色体异常组为20.3%，对照组为12%。一个包含既往剖宫产史、胎位异常、胎儿心率监护异常（NRFHR）和畸形存在情况的逻辑回归模型得出结论，畸形的存在不是剖宫产的独立危险因素。然而，间接原因，如胎位异常（比值比4.34），与畸形独立相关。
受CNS畸形或染色体异常影响的胎儿妊娠和分娩并发症发生率较高，包括那些增加产妇发病和死亡风险的并发症。
