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早产分娩方式的新生儿结局

Neonatal Outcomes by Mode of Delivery in Preterm Birth.

作者信息

Blue Nathan R, Van Winden Kristi R, Pathak Bhuvan, Barton Lorayne, Opper Neisha, Lane Christianne Joy, Ramanathan Rangasamy, Ouzounian Joseph G, Lee Richard H

机构信息

Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Keck School of Medicine, University of Southern California, Los Angeles, California.

Division of Neonatology, Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, California.

出版信息

Am J Perinatol. 2015 Dec;32(14):1292-7. doi: 10.1055/s-0035-1562931. Epub 2015 Sep 7.

Abstract

OBJECTIVE

We set out to test the hypothesis that infants born vaginally at ≤ 30 weeks gestation have less respiratory distress syndrome (RDS) than those born by cesarean delivery.

STUDY DESIGN

We conducted a retrospective cohort study of 652 infants born between 24 and 30 (6/7) weeks gestation from March 31, 1996 to May 31, 2014. Comparisons of neonatal outcomes by intended and actual mode of delivery were made using chi-square and t-tests (α = 0.05). Multiple logistic regression was performed to control for confounding variables.

RESULTS

Neonates born by cesarean delivery were more likely to have RDS (odds ratio [OR], 1.79; 95% confidence interval [CI], 1.10-2.90), require intubation (OR, 1.80; 95% CI, 1.12-2.88), and have longer neonatal intensive care unit stay (70.0 ± 37.1 vs. 57.3 ± 40.1 days, p = 0.02).

CONCLUSION

Compared with cesarean delivery, vaginal delivery is associated with a significant reduction in RDS among infants born at ≤ 30 weeks gestation.

摘要

目的

我们着手检验以下假设,即妊娠≤30周经阴道出生的婴儿患呼吸窘迫综合征(RDS)的情况少于剖宫产出生的婴儿。

研究设计

我们对1996年3月31日至2014年5月31日期间妊娠24至30(6/7)周出生的652名婴儿进行了一项回顾性队列研究。使用卡方检验和t检验(α = 0.05)对预期分娩方式和实际分娩方式的新生儿结局进行比较。进行多因素逻辑回归以控制混杂变量。

结果

剖宫产出生的新生儿更有可能患RDS(优势比[OR],1.79;95%置信区间[CI],1.10 - 2.90),需要插管(OR,1.80;95%CI,1.12 - 2.88),并且新生儿重症监护病房住院时间更长(70.0 ± 37.1天对57.3 ± 40.1天,p = 0.02)。

结论

与剖宫产相比,阴道分娩与妊娠≤30周出生的婴儿RDS显著减少相关。

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