Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea.
J Korean Med Sci. 2018 Feb 12;33(7):e51. doi: 10.3346/jkms.2018.33.e51.
The objective of this study was to assess the risk of emergency cesarean deliveries (CDs) and adverse neonatal/maternal outcomes according to the planned gestational age at delivery (GAD) for elective CD.
The study population consisted of term singleton pregnant women who were booked for elective CD and were subsequently delivered at term by CD, after excluding cases with a trial of labor. The relationship between the planned GAD, risk of emergency CD prior to planned date, and adverse neonatal/maternal outcomes were determined.
The frequency of emergency CD, adverse neonatal and maternal outcomes were 9.5%, 4.5%, and 5.9%, respectively. The risk of emergency CD prior to the planned delivery date increased significantly according to the planned GAD (5.8% at 37 weeks, 8.2% at 38 weeks, 13.6% at 39 weeks, and 26.7% at 40 weeks or more of planned GAD, P = 0.005). Emergency CD was associated with an increased risk of adverse maternal outcomes, whereas the risk of adverse neonatal outcomes did not differ. In the total study population including both cases with elective and emergency CD, the risk of adverse maternal outcomes did not increase according to the planned GAD, and the risk of adverse neonatal outcomes decreased significantly according to the planned GAD.
The risk of emergency CD increased as the planned GAD increased, but the risk of adverse maternal outcomes did not increase and the risk of adverse neonatal outcomes decreased significantly according to the planned GAD in the total study population including elective/emergency CD.
本研究旨在评估根据择期剖宫产（CD）的计划分娩孕周（GAD）评估紧急 CD 及不良新生儿/产妇结局的风险。
研究人群为择期 CD 并随后足月经 CD 分娩的单胎足月孕妇，排除试产病例。确定计划 GAD 与计划日期前紧急 CD 的风险以及不良新生儿/产妇结局之间的关系。
紧急 CD、不良新生儿和产妇结局的发生率分别为 9.5%、4.5%和 5.9%。根据计划 GAD，紧急 CD 的风险显著增加（37 周时为 5.8%，38 周时为 8.2%，39 周时为 13.6%，40 周或以上时为 26.7%，P=0.005）。紧急 CD 与产妇不良结局风险增加相关，而与新生儿不良结局风险无关。在包括择期和紧急 CD 的总研究人群中，根据计划 GAD，产妇不良结局风险并未增加，而新生儿不良结局风险显著降低。
在包括择期/紧急 CD 的总研究人群中，随着计划 GAD 的增加，紧急 CD 的风险增加，但产妇不良结局风险并未增加，而新生儿不良结局风险显著降低。
