Ertuğrul Serkan, Gün Ismet, Müngen Ercüment, Muhçu Murat, Kılıç Selim, Atay Vedat
GATA Haydarpaşa Training Hospital, Department of Obstetrics and Gynecology, İstanbul Clinic Department of Epidemiology and Public Health, Gülhane Military Medical School, Ankara, Turkey.
J Obstet Gynaecol Res. 2013 Jan;39(1):105-12. doi: 10.1111/j.1447-0756.2012.01951.x. Epub 2012 Aug 13.
Our aim is to evaluate the association between gestational age at delivery and neonatal outcomes in elective cesarean delivery.
A total of 1784 viable singleton pregnancies that were delivered by elective caesarean section at term were included in the study. All pregnancies were categorized according to the number of completed weeks of gestation (37(+0-6) , 38(+0-6) , 39(+0-6) and ≥40(+0) weeks). In this study, the patient groups compared in terms of demographic characteristics and neonatal outcomes.
The rates of the neonatal intensive care unit admission were 8.7%. When maternal and neonatal characteristics were statistically analyzed, the incidence of advanced maternal age and previous cesarean delivery increased as gestational age at delivery decreased; the incidence of nuchal cord and delivering a baby of ≥4000 g at birth increased as gestational age at delivery increased. As compared with deliveries at 39 weeks, cesarean delivery at 37 weeks of gestation had significantly higher risk, including that of neonatal intensive care unit admission, transient tachypnea of the newborn after delivery and O(2) support. There was one perinatal death observed in the study.
According to the results of our study, compared to elective cesarean delivery after 37 weeks of gestation, elective cesarean delivery at 37 weeks of gestation was associated with a statistically significant increase in neonatal mortality. Therefore, elective cesarean delivery should not be performed at 37 weeks of gestation and 39 weeks of gestation appears to be the ideal timing for elective cesarean delivery.
我们的目的是评估择期剖宫产分娩时的孕周与新生儿结局之间的关联。
本研究纳入了1784例足月择期剖宫产分娩的存活单胎妊娠。所有妊娠根据妊娠完成周数（37（+0 - 6）、38（+0 - 6）、39（+0 - 6）和≥40（+0）周）进行分类。在本研究中，对患者组的人口统计学特征和新生儿结局进行了比较。
新生儿重症监护病房收治率为8.7%。对母婴特征进行统计学分析时，随着分娩孕周的减少，高龄产妇和既往剖宫产的发生率增加；随着分娩孕周的增加，脐带绕颈和出生体重≥4000g的婴儿发生率增加。与39周分娩相比，37周妊娠时剖宫产的风险显著更高，包括新生儿重症监护病房收治、产后新生儿短暂性呼吸急促和氧气支持。本研究中观察到1例围产期死亡。
根据我们的研究结果，与妊娠37周后择期剖宫产相比，妊娠37周时择期剖宫产的新生儿死亡率在统计学上显著增加。因此，不应在妊娠37周时进行择期剖宫产，妊娠39周似乎是择期剖宫产的理想时机。
