Narayen Ilona C, Mulder Estelle E M, Boers Kim E, van Vonderen Jeroen J, Wolters Vera E R A, Freeman Liv M, Te Pas Arjan B
Division of Neonatology, Department of Pediatrics, Leiden University Medical Center, Leiden, Netherlands.
Department of Pediatrics, Isala Clinics, Zwolle, Netherlands.
Front Pediatr. 2018 Feb 12;6:20. doi: 10.3389/fped.2018.00020. eCollection 2018.
Although little data are available concerning safety for newborns, family-centered caesarean sections (FCS) are increasingly implemented. With FCS mothers can see the delivery of their baby, followed by direct skin-to-skin contact. We evaluated the safety for newborns born with FCS in the Leiden University Medical Center (LUMC), where FCS was implemented in June 2014 for singleton pregnancies with a gestational age (GA) ≥38 weeks and without increased risks for respiratory morbidity.
The incidence of respiratory pathology, unplanned admission, and hypothermia in infants born after FCS in LUMC were retrospectively reviewed and compared with a historical cohort of standard elective cesarean sections (CS).
From June 2014 to November 2015, 92 FCS were performed and compared to 71 standard CS in 2013. Incidence of respiratory morbidity, hypothermia, temperatures at arrival at the department, GA, and birth weight were comparable (ns). Unplanned admission occurred more often after FCS when compared to standard CS (21 vs 7%; = 0.03), probably due to peripheral oxygen saturation (SpO) monitoring. There was no increase in respiratory pathology (8 vs 6%, ns). One-third of the babies were separated from their mother during or after FCS.
Unplanned neonatal admissions after elective CS increased after implementing FCS, without an increase in respiratory morbidity or hypothermia. SpO monitoring might have a contribution. Separation from the mother occurred often.
尽管关于新生儿安全性的数据较少，但以家庭为中心的剖宫产（FCS）正在越来越多地实施。通过FCS，母亲可以看到婴儿的出生，随后进行直接的皮肤接触。我们评估了在莱顿大学医学中心（LUMC）通过FCS出生的新生儿的安全性，该中心于2014年6月对孕周（GA）≥38周且无呼吸疾病风险增加的单胎妊娠实施了FCS。
回顾性分析了LUMC中FCS术后出生婴儿的呼吸病理、意外入院和体温过低的发生率，并与标准择期剖宫产（CS）的历史队列进行比较。
2014年6月至2015年11月，共进行了92例FCS，并与2013年的71例标准CS进行比较。呼吸疾病、体温过低、到达科室时的体温、GA和出生体重的发生率相当（无显著性差异）。与标准CS相比，FCS术后意外入院的情况更常见（21%对7%；P = 0.03），可能是由于外周血氧饱和度（SpO）监测。呼吸病理情况没有增加（8%对6%，无显著性差异）。三分之一的婴儿在FCS期间或之后与母亲分开。
实施FCS后，择期剖宫产后新生儿意外入院增加，但呼吸疾病或体温过低没有增加。SpO监测可能有一定作用。婴儿与母亲经常分开。
