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早期选择性足月分娩新生儿的发病情况。

Morbidities in Neonates Delivered Electively at Early Term.

作者信息

Razak Abdul, Nagesh Karthik N, Karthik Gayathri, Pillai Mrinal S, Mohanty Pankaj Kumar

机构信息

Department of Neonatology, Manipal Hospital, Bangalore, India.

Department of Neonatology, Manipal Hospital, Bangalore, India ; Manipal Group of Hospitals, Bangalore, India.

出版信息

J Obstet Gynaecol India. 2016 Aug;66(4):248-51. doi: 10.1007/s13224-015-0739-0. Epub 2015 Jul 21.

Abstract

OBJECTIVE

To study the incidence of elective cesarean deliveries at term and to correlate their neonatal outcomes at different gestational ages (37(0/7)-40(6/7)).

METHODS

Outcomes including the rate of NICU admissions, usage of ventilator/CPAP, and other morbidities were analysed and compared with the gestational age during the study period from January 2012 to April 2013.

RESULTS

The incidences of elective deliveries at 37, 38, 39, and 40 weeks of gestation were 10.6, 29.7, 28, and 31.5 %, respectively. NICU admissions-RR 3.94 (95 % CI 1.92-8.09), respiratory distress-RR 5.255 (95 % CI 1.9-14.4), ventilatory usage, and hospitalization stay (P value < 0.05) were higher in neonates born at 37(0/7-6/7) versus 39(0/7-6/7) weeks (least morbidity group).

CONCLUSION

Despite recommendations, more than one-third of term babies are delivered electively at <39 weeks. The fivefold augmented respiratory morbidity and fourfold increased NICU admissions in early term neonates, and the least morbidity in neonates delivered at 39 weeks emphasize the importance of restricting the non-emergent/elective deliveries to 39 weeks of gestation.

摘要

目的

研究足月选择性剖宫产的发生率,并将不同孕周(37(0/7)-40(6/7)周)的新生儿结局进行关联分析。

方法

分析包括新生儿重症监护病房(NICU)入住率、呼吸机/持续气道正压通气(CPAP)使用率及其他疾病发生率等结局指标,并与2012年1月至2013年4月研究期间的孕周进行比较。

结果

妊娠37、38、39和40周时选择性分娩的发生率分别为10.6%、29.7%、28%和31.5%。与妊娠39(0/7-6/7)周(发病率最低组)出生的新生儿相比,妊娠37(0/7-6/7)周出生的新生儿NICU入住率-相对危险度(RR)3.94(95%置信区间[CI]1.92-8.09)、呼吸窘迫-RR 5.255(95%CI 1.9-14.4)、呼吸机使用率及住院时间(P值<0.05)更高。

结论

尽管有相关建议,但超过三分之一的足月儿在<39周时进行了选择性分娩。早期足月儿呼吸疾病发病率增加五倍,NICU入住率增加四倍,而39周出生的新生儿发病率最低,这强调了将非紧急/选择性分娩限制在妊娠39周的重要性。

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