超声估计胎儿体重：剖宫产的可修正危险因素？
Estimated fetal weight by ultrasound: a modifiable risk factor for cesarean delivery?
机构信息
Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Boston, MA, USA.
出版信息
Am J Obstet Gynecol. 2012 Oct;207(4):309.e1-6. doi: 10.1016/j.ajog.2012.06.065. Epub 2012 Jul 9.
OBJECTIVE
The purpose of this study was to investigate whether knowledge of ultrasound-obtained estimated fetal weight (US-EFW) is a risk factor for cesarean delivery (CD).
STUDY DESIGN
Retrospective cohort from a single center in 2009-2010 of singleton, term live births. CD rates were compared for women with and without US-EFW within 1 month of delivery and adjusted for potential confounders.
RESULTS
Of the 2329 women in our cohort, 50.2% had US-EFW within 1 month of delivery. CD was significantly more common for women with US-EFW (15.7% vs 10.2%; P < .001); after we controlled for confounders, US-EFW remained an independent risk factor for CD (odds ratio, 1.44; 95% confidence interval, 1.1-1.9). The risk increased when US-EFW was >3500 g (odds ratio, 1.8; 95% confidence interval, 1.3-2.7).
CONCLUSION
Knowledge of US-EFW, above and beyond the impact of fetal size itself, increases the risk of CD. Acquisition of US-EFW near term appears to be an independent and potentially modifiable risk factor for CD.
目的
本研究旨在探讨是否了解超声估计胎儿体重（US-EFW）是剖宫产（CD）的危险因素。
研究设计
这是 2009 年至 2010 年在单中心进行的回顾性队列研究，纳入足月单胎活产。比较了分娩前 1 个月内有和没有 US-EFW 的女性的 CD 发生率，并对潜在混杂因素进行了调整。
结果
在我们的队列中，2329 名女性中有 50.2%在分娩前 1 个月内进行了 US-EFW。有 US-EFW 的女性 CD 发生率明显更高（15.7%比 10.2%；P<.001）；在控制了混杂因素后，US-EFW 仍然是 CD 的独立危险因素（比值比，1.44；95%置信区间，1.1-1.9）。当 US-EFW>3500 g 时，风险增加（比值比，1.8；95%置信区间，1.3-2.7）。
结论
除了胎儿大小本身的影响外，了解 US-EFW 会增加 CD 的风险。在接近分娩时获得 US-EFW 似乎是 CD 的一个独立的、潜在可改变的危险因素。
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