Lee Hye Ran, Kim Mi-Na, You Ji Yeon, Choi Suk-Joo, Oh Soo-Young, Roh Cheong-Rae, Kim Jong-Hwa
Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Obstet Gynecol Sci. 2015 Sep;58(5):346-52. doi: 10.5468/ogs.2015.58.5.346. Epub 2015 Sep 22.
To investigate whether the cesarean section (CS) rate is increased in women whose labor was induced compared to those who had spontaneous labor at term pregnancy.
A retrospective study was performed in women whose labor was either induced (induction group, n=497) or spontaneous (spontaneous group, n=878) at 37+0 to 41+6 weeks of gestation from January 2008 to June 2009. Maternal age, parity, body mass index (BMI), Bishop scores, gestational age, hypertension, diabetes, delivery mode, indications for CS, neonatal outcome were compared between the two groups. Multiple logistic regression analysis was used to examine the association between the CS rate and labor induction after adjusting for potential confounding variables.
CS (17.3% vs. 5.3%, P<0.001) and vacuum-assisted delivery (10.7% vs. 6.4%, P<0.001) rates were significantly higher in the induction group compared to the spontaneous group. The CS rate in the induction group was higher than the spontaneous group not only in nulliparous women (25.3% vs. 8.6%, P<0.001), but also in multiparous women (3.8% vs. 0.3%, P=0.002). However, after adjusting confounding factors, the higher CS rate was significantly associated with advanced maternal age, higher BMI, lower Bishop scores and nulliparity, with no demonstrable tie to labor induction. Neonatal outcome in the two groups were comparable.
Although CS rate was higher in women whose labor was induced than those who had spontaneous labor, this higher rate was associated with maternal age, BMI, Bishop scores and parity, but was not impacted by labor induction per se.
探讨足月妊娠时引产的女性与自然分娩的女性相比，剖宫产（CS）率是否升高。
对2008年1月至2009年6月在妊娠37⁺⁰至41⁺⁶周期间引产（引产组，n = 497）或自然分娩（自然分娩组，n = 878）的女性进行回顾性研究。比较两组产妇的年龄、产次、体重指数（BMI）、Bishop评分、孕周、高血压、糖尿病、分娩方式、剖宫产指征、新生儿结局。采用多因素logistic回归分析，在调整潜在混杂变量后，检验剖宫产率与引产之间的关联。
与自然分娩组相比，引产组的剖宫产率（17.3%对5.3%，P<0.001）和真空辅助分娩率（10.7%对6.4%，P<0.001）显著更高。引产组的剖宫产率不仅在初产妇中高于自然分娩组（25.3%对8.6%，P<0.001），在经产妇中也更高（3.8%对0.3%，P = 0.002）。然而，在调整混杂因素后，较高的剖宫产率与产妇年龄较大、BMI较高、Bishop评分较低和初产显著相关，与引产无明显关联。两组的新生儿结局相当。
虽然引产的女性剖宫产率高于自然分娩的女性，但这种较高的剖宫产率与产妇年龄、BMI、Bishop评分和产次有关，而不是引产本身的影响。
