Zhao Lei, Lin Ying, Jiang Ting-Ting, Wang Ling, Li Min, Wang Ying, Sun Guo-Qiang, Xiao Mei
a Department of Obstetric , Hubei Maternal and Child Health Hospital , Hongshan District, Wuhan , China.
J Matern Fetal Neonatal Med. 2019 May;32(10):1721-1727. doi: 10.1080/14767058.2017.1416351. Epub 2017 Dec 21.
This study aimed to qualify relevant factors for vaginal delivery among women who underwent labor induction with vaginal dinoprostone (PGE2) insert in a Chinese tertiary maternity hospital.
A retrospective study was conducted in Hubei Maternal and Child Health Hospital. A total of 1656 pregnancies that underwent labor induction with vaginal dinoprostone insert between January and August 2016 were finally included in this study. Data were analyzed using univariate and multivariable regression modeling.
Of 1656 women with PGE2-induced labor at term, 396 (23.91%) gave birth by cesarean section, 1260 (76.09%) had a vaginal delivery among which 921 (55.61%) delivered vaginally within 24 h. Multivariable regression analysis showed that maternal age (p < .001, OR = 0.89, 95%CI 0.85-0.93), parity (multiparous versus nulliparous, p < .001, OR = 8.74, 95%CI 4.36-17.50), baseline fetal heart rate (p = .009, OR = 0.98, 95%CI 0.96-0.99), and birth weight (p < .001, OR = 0.37, 95%CI 0.28-0.51) were significantly correlated with vaginal delivery. Moreover, body mass index (p < .001, OR = 1.11, 95%CI 1.05-1.19), parity (multiparous versus nulliparous, p < .001, OR = 6.57, 95%CI 2.37-18.23), baseline fetal heart rate (p = .004, OR = 0.96, 95%CI 0.94-0.99), and birth weight (p < .001, OR = 0.34, 95%CI 0.21-0.54) were independent predictors of vaginal delivery within 24-h.
Our findings suggested a vaginal delivery rate of 76.09% when dinoprostone vaginal insert was used for labor induction, which was markedly higher than the overall annual vaginal delivery rate of 65.1% in China during 2014. Maternal age, parity, baseline fetal heart rate, and birth weight were significant factors for vaginal delivery. This study enables us to better understand the efficiency of dinoprostone and the potential predictors of vaginal delivery in dinoprostone-induced labor, which may be helpful to guide the clinical use of dinoprostone and therefore provide better service clinically.
本研究旨在确定在中国一家三级妇产医院接受阴道用地诺前列酮（PGE2）栓剂引产的女性中阴道分娩的相关因素。
在湖北省妇幼保健院进行了一项回顾性研究。最终纳入了2016年1月至8月间1656例接受阴道用PGE2栓剂引产的妊娠病例。采用单因素和多因素回归模型进行数据分析。
在1656例足月使用PGE2引产的女性中，396例（23.91%）行剖宫产，1260例（76.09%）经阴道分娩，其中921例（55.61%）在24小时内阴道分娩。多因素回归分析显示，产妇年龄（p＜0.001，OR = 0.89，95%CI 0.85 - 0.93）、产次（经产妇与初产妇，p＜0.001，OR = 8.74，95%CI 4.36 - 17.50）、基线胎心率（p = 0.009，OR = 0.98，95%CI 0.96 - 0.99）和出生体重（p＜0.001，OR = 0.37，95%CI 0.28 - 0.51）与阴道分娩显著相关。此外，体重指数（p＜0.001，OR = 1.11，95%CI 1.05 - 1.19）、产次（经产妇与初产妇，p＜0.001，OR = 6.57，95%CI 2.37 - 18.23）、基线胎心率（p = 0.004，OR = 0.96×，95%CI 0.94 - 0.99）和出生体重（p＜0.001，OR = 0.34，95%CI 0.21 - 0.54）是24小时内阴道分娩的独立预测因素。
我们的研究结果表明，使用地诺前列酮阴道栓剂引产时，阴道分娩率为76.09%，明显高于2014年中国全年65.1%的总体阴道分娩率。产妇年龄、产次、基线胎心率和出生体重是阴道分娩的重要因素。本研究有助于我们更好地了解地诺前列酮的有效性以及地诺前列酮引产中阴道分娩的潜在预测因素，这可能有助于指导地诺前列酮的临床应用，从而在临床上提供更好的服务。
