Aviram Amir, Ashwal Eran, Hiersch Liran, Yogev Yariv
Lis Maternity and Women's Hospital, Tel-Aviv Sourasky Medical Center, Tel-Aviv; Affiliated to the Sackler Faculty of Medicine, Tel-Aviv University, Ramat-Aviv, Israel.
Arch Gynecol Obstet. 2018 Feb;297(2):341-346. doi: 10.1007/s00404-017-4608-1. Epub 2017 Nov 28.
To evaluate the impact of vacuum extraction on birth injuries among low birth weight neonate (2000-2499 g).
Retrospective cohort study of women with singleton pregnancies > 34 weeks, birth weight of 2000-3500 g, undergoing vacuum extraction, between 2007 and 2014. Outcomes were compared between neonates who weighed 2000-2499 g and 2500-3500 g.
Out of 62,102 deliveries, 5064 (8.2%) met the inclusion criteria, of which 269 (5.3%) neonates were included in the 2000-2499 g group. In this group, gestational age at delivery was lower, the rate of preeclampsia without and with severe features was higher, the rate of induction of labor was higher as was the rate of intermediate/abnormal fetal heart rate tracings as an indication for vacuum extraction (46.2% vs. 28.0%, P < 0.001). No difference was found with regards to birth injuries (2.6% vs. 3.5%, P = 0.44). The rate of composite adverse outcomes other than birth injuries was higher in the 2000-2499 g group (13.0% vs. 9.1%, P = 0.03). Each additional 250 g in birth weight had an increased OR of 1.36 for birth injuries.
Vacuum extraction of neonates weighing 2000-2499 g seems to be as safe as vacuum extractions of neonates weighing 2500-3500 g in term of birth injuries.
评估真空吸引术对低出生体重新生儿（2000 - 2499克）出生损伤的影响。
对2007年至2014年间单胎妊娠超过34周、出生体重2000 - 3500克且接受真空吸引术的妇女进行回顾性队列研究。比较体重2000 - 2499克和2500 - 3500克新生儿的结局。
在62102例分娩中，5064例（8.2%）符合纳入标准，其中269例（5.3%）新生儿被纳入2000 - 2499克组。该组中，分娩时的孕周较低，无严重特征和有严重特征的子痫前期发生率较高，引产率较高，作为真空吸引术指征的中度/异常胎儿心率描记图发生率也较高（分别为46.2%和28.0%，P < 0.001）。在出生损伤方面未发现差异（分别为2.6%和3.5%，P = 0.44）。2000 - 2499克组中除出生损伤外的复合不良结局发生率较高（分别为13.0%和9.1%，P = 0.03）。出生体重每增加250克，出生损伤的优势比增加1.36。
就出生损伤而言，对体重2000 - 2499克的新生儿进行真空吸引术似乎与对体重2500 - 3500克的新生儿进行真空吸引术一样安全。
