计划性早产趋势：一项基于人群的研究。

Trends in planned early birth: a population-based study.

机构信息

Department of Obstetrics, Gynaecology, and Neonatology, University of Sydney at Royal North Shore Hospital, St Leonards, Sydney, Australia.

出版信息

Am J Obstet Gynecol. 2012 Sep;207(3):186.e1-8. doi: 10.1016/j.ajog.2012.06.082. Epub 2012 Jul 10.

DOI:10.1016/j.ajog.2012.06.082

PMID:22939720

Abstract

OBJECTIVE

The purpose of this study was to describe trends and outcomes of planned births.

STUDY DESIGN

Data from linked birth and hospital records for 779,521 singleton births at ≥33 weeks' gestation from 2001-2009 were used to determine trends in planned births (prelabor cesarean section and labor inductions). Adverse outcomes were composite indicators of maternal and neonatal morbidity/death.

RESULTS

From 2001-2009, there were increases in labor inductions and prelabor cesarean deliveries at <40 weeks' gestation, but no decrease in the stillbirth rate (trend P = .34). By 2009, 14.9% of live births at ≥33 weeks' gestation were prelabor cesarean deliveries before the due date; 11.4% were inductions. As planned births increased, maternal risks shifted, which included a decline in inductions with maternal hypertension from 31.9-23.9%. Earlier birth was contemporaneous with increases (trend P < .001) in neonatal and maternal morbidity rates from 3.0-3.2% and 1.1-1.5%, respectively.

CONCLUSION

Planned birth before the due date is increasing without a contemporaneous reduction of stillbirths.

摘要

目的

本研究旨在描述计划性分娩的趋势和结局。

研究设计

本研究使用了 2001-2009 年期间≥33 孕周的 779521 例单胎分娩的母婴健康记录，以确定计划性分娩（产前剖宫产和引产）的趋势。不良结局是产妇和新生儿发病率/死亡率的综合指标。

结果

2001-2009 年，<40 孕周的引产和产前剖宫产分娩有所增加，但死产率没有下降（趋势 P =.34）。到 2009 年，≥33 孕周的活产儿中有 14.9%是在预产期前进行的产前剖宫产分娩；11.4%是引产。随着计划性分娩的增加，产妇的风险也发生了变化，其中产妇高血压引产的比例从 31.9%降至 23.9%。更早的分娩与新生儿和产妇发病率的增加同时发生（趋势 P <.001），发病率分别从 3.0%升至 3.2%和从 1.1%升至 1.5%。