Litorp Helena, Rööst Mattias, Kidanto Hussein L, Nyström Lennarth, Essén Birgitta
International Maternal and Child Health (IMCH), Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
International Maternal and Child Health (IMCH), Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
Int J Gynaecol Obstet. 2016 May;133(2):183-7. doi: 10.1016/j.ijgo.2015.10.009. Epub 2016 Jan 15.
To investigate if multiparous individuals who had undergone a previous cesarean delivery experienced an increased risk of severe maternal outcomes or adverse perinatal outcomes compared with multiparous individuals who had undergone previous vaginal deliveries.
An analytical cross-sectional study at a university hospital in Dar es Salaam, Tanzania, enrolled multiparous participants of at least 28weeks of pregnancy between February 1 and June 30, 2012 . Data were collected from patients' medical records and the hospital's obstetric database. Odds ratios (OR) and 95% confidence intervals (CI) were calculated to compare outcomes among patients who had or had not undergone previous cesarean deliveries.
A total of 2478 patients were enrolled. A previous cesarean delivery resulted in no increase in the risk of severe maternal outcomes (OR 0.86, 95% CI 0.58-1.26; P=0.46), and decreased risk of stillbirth (OR 0.42, 95% CI 0.29-0.62, P<0.001), and intrapartum stillbirth and neonatal distress (OR 0.58, 95% CI 0.38-0.87, P=0.007).
Previous cesarean delivery was not a risk factor for severe maternal outcomes or adverse perinatal outcomes. The present study was conducted at a referral institution, where individuals with previous cesarean deliveries may constitute a healthy group. Additionally, there could be differences between the study groups in terms of healthcare-seeking behavior, referral mechanisms, intrapartum monitoring, and clinical decision making.
调查与曾有过阴道分娩的经产妇相比，曾行剖宫产的经产妇发生严重孕产妇结局或不良围产期结局的风险是否增加。
在坦桑尼亚达累斯萨拉姆的一家大学医院进行的一项分析性横断面研究，纳入了2012年2月1日至6月30日期间怀孕至少28周的经产妇。数据从患者的病历和医院的产科数据库中收集。计算比值比（OR）和95%置信区间（CI），以比较曾行或未行剖宫产的患者的结局。
共纳入2478例患者。既往剖宫产并未增加严重孕产妇结局的风险（OR 0.86，95%CI 0.58-1.26；P=0.46），且降低了死产风险（OR 0.42，95%CI 0.29-0.62，P<0.001）以及产时死产和新生儿窘迫风险（OR 0.58，95%CI 0.38-0.87，P=0.007）。
既往剖宫产不是严重孕产妇结局或不良围产期结局的危险因素。本研究是在一家转诊机构进行的，在该机构中，既往有剖宫产史的个体可能构成一个健康群体。此外，研究组之间在就医行为、转诊机制、产时监测和临床决策方面可能存在差异。
