Department of Plastic and Reconstructive Surgery and Hand Surgery, Sophia Children's Hospital, Erasmus University Medical Centre, Room EE-1591, Postbus 2040, 3000CA, Rotterdam, The Netherlands.
University of Gothenburg, The Sahlgrenska Academy, Institute of Clinical Sciences, Department of Plastic Surgery, Sahlgrenska University Hospital, Gröna Straket 8, 413 45, Goteborg, Sweden.
J Craniomaxillofac Surg. 2017 Nov;45(11):1809-1814. doi: 10.1016/j.jcms.2017.08.012. Epub 2017 Aug 19.
Craniosynostosis may lead to hampered fetal head molding and birth complications. To study the interaction between single suture craniosynostosis and delivery complications, an international, multicentre, retrospective cohort study was performed.
All infants born between 2006 and 2012 in the Netherlands and Sweden with sagittal or metopic suture synostosis were included. All births were included as a reference population. The primary outcome measure was rate of medically assisted labor. The secondary outcomes included method of conception, term of birth and fetal position.
We included 152 trigonocephaly patients, 272 scaphocephaly patients and 1.954.141 controls. A higher rate of assisted reproductive technology (ART) was found in patients with trigonocephaly (13%) and scaphocephaly (7%) compared to controls (3%, p < 0.001). Scaphocephaly resulted in more postterm births (8% vs 4%, p < 0.001). Trigonocephaly patients showed more preterm births (11% vs 6%, p < 0.001), breech position was more frequent (10% vs 4%, p = 0.003) and labor was more often induced. Rate of assisted delivery, including cesarean section, was significantly higher in both patient groups.
Scaphocephaly leads to more postterm births and an increased rate of cesarean sections. Trigonocephaly is related to ART, and in addition higher rates of breech position and cesarean section are found. Prenatal detection of single suture craniosynostosis could improve perinatal care.
颅缝早闭可能导致胎儿头部塑形受阻和分娩并发症。为了研究单一颅缝早闭与分娩并发症之间的相互作用,进行了一项国际多中心回顾性队列研究。
纳入 2006 年至 2012 年期间在荷兰和瑞典出生的矢状缝或额缝早闭的所有婴儿,并将所有分娩作为参考人群。主要结局指标为医疗辅助分娩的发生率。次要结局指标包括受孕方式、出生时胎龄和胎儿位置。
我们纳入了 152 例三角头畸形患者、272 例舟状头畸形患者和 1954141 例对照。与对照组(3%)相比,三角头畸形(13%)和舟状头畸形(7%)患者的辅助生殖技术(ART)比例更高(p<0.001)。舟状头畸形患者的过期产(8%比 4%,p<0.001)更多。三角头畸形患者的早产儿更多(11%比 6%,p<0.001),臀位更常见(10%比 4%,p=0.003),且分娩更常采用诱导。两组患者的辅助分娩率(包括剖宫产)均显著升高。
舟状头畸形导致更多过期产和剖宫产率增加。三角头畸形与 ART 相关,此外,臀位和剖宫产率也更高。对单一颅缝早闭的产前检测可以改善围产期护理。