Posthuma Selina, Korteweg Fleurisca J, van der Ploeg J Marinus, de Boer Hans D, Buiter Hannah D, van der Ham David P
a Department of Obstetrics and Gynecology.
b Department of Anesthesiology and Pain medicine , and.
J Matern Fetal Neonatal Med. 2017 Jan;30(2):159-163. doi: 10.3109/14767058.2016.1163683. Epub 2016 Mar 29.
Comparing maternal and neonatal outcomes after conventional cesarean section (CS) versus a "natural" or "skin-to-skin" cesarean section (SSCS).
Retrospective cohort of women who underwent a SSCS (01-2013 until 12-2013) compared to conventional CS (08-2011 to 08-2012). CS before 37 weeks, under general anesthesia and in case of fetal distress were excluded. Main outcome measures were maternal blood loss, post-operative infection and admission; neonatal infection and admission; procedural outcomes.
We analyzed 285 (44%) women in the SSCS-group and 365 (56%) in the conventional CS-group. There were no significant differences in surgical site infection (2.1% versus 1.6%; RR 1.1; 95%CI 0.64-2.0), or other maternal outcomes. Fewer neonates born after SSCS were admitted to the pediatric ward (9.5% versus 18%; RR 0.58; 95%CI 0.41-0.80) and fewer neonates had a suspected neonatal infection (2.0% versus 7.3%; RR 0.40; 95%CI 0.19-0.83). No differences were observed for other outcomes. Mean operation time was 4m42s longer in the SSCS-group compared to the conventional CS-group (58m versus 53m; 95%CI 2m44s-6m40s). Mean recovery time was 14m46s shorter (114m versus 129m; 95%CI 3m20s-26m).
Adverse maternal and neonatal outcomes were not increased after skin-to-skin cesarean compared to conventional cesarean delivery.
比较传统剖宫产（CS）与“自然”或“母婴皮肤接触”剖宫产（SSCS）后的母婴结局。
对2013年1月至2013年12月接受SSCS的女性与2011年8月至2012年8月接受传统CS的女性进行回顾性队列研究。排除37周前剖宫产、全身麻醉下剖宫产及胎儿窘迫情况下的剖宫产。主要结局指标包括产妇失血、术后感染及住院情况；新生儿感染及住院情况；手术结局。
我们分析了SSCS组中的285名（44%）女性和传统CS组中的365名（56%）女性。手术部位感染（2.1%对1.6%；相对危险度1.1；95%置信区间0.64 - 2.0）或其他产妇结局方面无显著差异。SSCS后出生的新生儿入住儿科病房的较少（9.5%对18%；相对危险度0.58；95%置信区间0.41 - 0.80），疑似新生儿感染的也较少（2.0%对7.3%；相对危险度0.40；95%置信区间0.19 - 0.83）。其他结局未观察到差异。与传统CS组相比，SSCS组平均手术时间长4分42秒（58分钟对53分钟；95%置信区间2分44秒 - 6分40秒）。平均恢复时间短14分46秒（114分钟对129分钟；95%置信区间3分20秒 - 26分钟）。
与传统剖宫产相比，母婴皮肤接触剖宫产术后母婴不良结局并未增加。
