低危产妇引产与期待管理的比较及相关围生期结局。
Induction of labor compared to expectant management in low-risk women and associated perinatal outcomes.
机构信息
Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology, and Reproductive Medicine, School of Medicine, University of California-San Francisco, CA, USA.
出版信息
Am J Obstet Gynecol. 2012 Dec;207(6):502.e1-8. doi: 10.1016/j.ajog.2012.09.019. Epub 2012 Sep 22.
OBJECTIVE
We sought to examine the association of labor induction and perinatal outcomes.
STUDY DESIGN
This was a retrospective cohort study of low-risk nulliparous women with term, live births. Women who had induction at a given gestational age (eg, 39 weeks) were compared to delivery at a later gestation (eg, 40, 41, or 42 weeks).
RESULTS
Compared to delivery at a later gestational age, those induced at 39 weeks had a lower risk of cesarean (adjusted odds ratio [aOR], 0.90; 95% confidence interval [CI], 0.88-0.91) and labor dystocia (aOR, 0.88; 95% CI, 0.84-0.94). Their neonates had lowered risk of having 5-minute Apgar <7 (aOR, 0.81; 95% CI, 0.72-0.92), meconium aspiration syndrome (aOR, 0.30; 95% CI, 0.19-0.48), and admission to neonatal intensive care unit (aOR, 0.87; 95% CI, 0.78-0.97). Similar findings were seen for women who were induced at 40 weeks compared to delivery later.
CONCLUSION
Induction of labor in low-risk women at term is not associated with increased risk of cesarean delivery compared to delivery later.
目的
我们旨在研究引产与围产结局的关系。
研究设计
这是一项回顾性队列研究，纳入的对象为低危初产妇足月活产儿。在特定孕周（如 39 周）行引产的产妇与在较晚孕周（如 40、41 或 42 周）分娩的产妇进行比较。
结果
与在较晚孕周分娩相比，在 39 周行引产的产妇剖宫产风险较低（校正比值比 [aOR]，0.90；95%置信区间 [CI]，0.88-0.91），分娩困难的风险也较低（aOR，0.88；95% CI，0.84-0.94）。其新生儿发生 5 分钟 Apgar 评分 <7 的风险较低（aOR，0.81；95% CI，0.72-0.92），胎粪吸入综合征的风险较低（aOR，0.30；95% CI，0.19-0.48），需要入住新生儿重症监护病房的风险也较低（aOR，0.87；95% CI，0.78-0.97）。在 40 周行引产的产妇与在较晚孕周分娩相比也有类似的发现。
结论
在足月低危产妇中引产与较晚分娩相比，剖宫产风险并未增加。
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