Croughan-Minihane M S, Petitti D B, Gordis L, Golditch I
Division of Research, Northern California Kaiser Permanente Medical Care Program, Oakland.
Obstet Gynecol. 1990 May;75(5):821-5.
To determine whether vaginally born breech infants are at increased risk for morbid events as compared with breech infants delivered by cesarean, we studied 1240 singleton breech infants without congenital anomalies delivered in Northern California Kaiser Permanente Medical Care Program hospitals during 1976-1977. Medical record review provided information on indications for method of delivery, delivery complications and injuries, neonatal complications, and neurologic sequelae up to 4 years of age. The relative risk estimates for asphyxia (1.0; 95% confidence interval 0.7, 1.4), head trauma (1.6; 95% confidence interval 0.2, 17.0), neonatal seizures (0.8; 95% confidence interval 0.1, 7.1), cerebral palsy (1.6; 95% confidence interval 0.2, 17.4), and developmental delay (2.0; 95% confidence interval 0.9, 4.4) for vaginally born compared with cesarean-delivered infants indicated that vaginally born infants were not at increased risk for these outcomes. We used multiple logistic regression to control for confounding variables. The adjusted relative risk estimate for the combined-outcome category of head trauma, neonatal seizures, cerebral palsy, mental retardation, or spasticity was 0.5 in vaginally delivered infants (95% confidence interval 0.1, 3.2). When all morbid outcomes were considered in combination, the adjusted relative risk estimate was 0.9 for vaginally delivered infants (95% confidence interval 0.6, 1.4).
为了确定与剖宫产出生的臀位婴儿相比，经阴道出生的臀位婴儿发生不良事件的风险是否增加，我们研究了1976 - 1977年期间在北加利福尼亚凯撒永久医疗保健计划医院出生的1240名单胎无先天性异常的臀位婴儿。病历审查提供了有关分娩方式指征、分娩并发症和损伤、新生儿并发症以及4岁前神经后遗症的信息。与剖宫产出生的婴儿相比，经阴道出生婴儿发生窒息（相对风险估计值为1.0；95%置信区间为0.7, 1.4）、头部创伤（相对风险估计值为1.6；95%置信区间为0.2, 17.0）、新生儿惊厥（相对风险估计值为0.8；95%置信区间为0.1, 7.1）、脑瘫（相对风险估计值为 , 1.6；95%置信区间为0.2, 17.4）和发育迟缓（相对风险估计值为2.0；95%置信区间为0.9, 4.4）的相对风险估计表明，经阴道出生的婴儿发生这些结局的风险并未增加。我们使用多元逻辑回归来控制混杂变量。经阴道分娩婴儿发生头部创伤、新生儿惊厥、脑瘫、智力迟钝或痉挛综合结局类别的调整后相对风险估计值为0.5（95%置信区间为0.1, 3.2）。当综合考虑所有不良结局时，经阴道分娩婴儿的调整后相对风险估计值为0.9（95%置信区间为0.6, 1.4）。
