Aviram Amir, Yogev Yariv, Bardin Ron, Hiersch Liran, Wiznitzer Arnon, Hadar Eran
Helen Schneider Hospital for Women, Rabin Medical Center, Petah Tikva, Israel; Sackler Faculty of Medicine, Tel-Aviv University, Ramat-Aviv, Israel.
Helen Schneider Hospital for Women, Rabin Medical Center, Petah Tikva, Israel; Sackler Faculty of Medicine, Tel-Aviv University, Ramat-Aviv, Israel.
Int J Gynaecol Obstet. 2016 Jan;132(1):72-6. doi: 10.1016/j.ijgo.2015.06.043. Epub 2015 Sep 25.
To evaluate the association between sonographically measured head circumference (HC) and labor outcome.
In a retrospective study at a tertiary medical center in Israel, data were reviewed for all term singleton deliveries between July 2007 and December 2012 with HC measurements up to 7days before delivery. HC was compared between women with operative vaginal delivery (OVD) or cesarean delivery for prolonged second stage and those with normal vaginal delivery. The impact of HC above the 75th percentile on pregnancy outcome was analyzed.
The study included 2351 women, of whom 2045 (87.0%) had a normal vaginal delivery, 259 (11.0%) underwent OVD, and 47 (2.0%) cesarean. Each 10mm increase in HC was associated with increased risk for obstetric intervention because of a prolonged second stage (adjusted odds ratio [aOR] 1.26; 95% confidence interval [CI] 1.08-1.46). HC above the 75th percentile was independently associated with increased odds of OVD (aOR 1.77; 95% CI 1.30-2.41), 1-minute Apgar score less than 7 (aOR 2.91; 95% CI 1.50-5.66), and neonatal asphyxia (aOR 2.19; 95% CI 1.02-4.71).
Term HC above the 75th percentile was associated with increased rates of obstetric interventions because of a prolonged second stage and might be associated with neonatal asphyxia.
评估超声测量的头围（HC）与分娩结局之间的关联。
在以色列一家三级医疗中心进行的一项回顾性研究中，对2007年7月至2012年12月期间所有足月单胎分娩且在分娩前7天内有头围测量数据的病例进行了回顾。比较了因第二产程延长而行阴道助产（OVD）或剖宫产的妇女与正常阴道分娩的妇女的头围。分析了头围高于第75百分位数对妊娠结局的影响。
该研究纳入了2351名妇女，其中2045名（87.0%）为正常阴道分娩，259名（11.0%）接受了阴道助产，47名（2.0%）接受了剖宫产。头围每增加10mm，因第二产程延长而进行产科干预的风险就增加（校正比值比[aOR]为1.26；95%置信区间[CI]为1.08 - 1.46）。头围高于第75百分位数与阴道助产几率增加（aOR为1.77；95%CI为1.30 - 2.41）、1分钟Apgar评分低于7分（aOR为2.91；95%CI为1.50 - 5.66）以及新生儿窒息（aOR为2.19；95%CI为1.02 - 4.71）独立相关。
足月头围高于第75百分位数与因第二产程延长导致的产科干预率增加有关，并且可能与新生儿窒息有关。
