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颈带对围产儿死亡率和长期后代发病率的影响。

The effect of nuchal cord on perinatal mortality and long-term offspring morbidity.

机构信息

Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel.

Department of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.

出版信息

J Perinatol. 2020 Mar;40(3):439-444. doi: 10.1038/s41372-019-0511-x. Epub 2019 Oct 8.

Abstract

OBJECTIVE

To evaluate perinatal and long-term cardiovascular and respiratory morbidities of children born with nuchal cord.

STUDY DESIGN

A large population-based cohort analysis of singleton deliveries was conducted. Maternal and birth characteristics, as well as cardiovascular and respiratory morbidity incidence were evaluated. Kaplan-Meier survival curves were used to compare cumulative hospitalization incidence between groups. Cox regression models were used to control for possible confounders and follow-up length.

RESULTS

243,682 deliveries were included. Of them, 34,332 (14.1%) were diagnosed with nuchal cord. Perinatal mortality rate was comparable between groups (0.5 vs. 0.6%, p = 0.16). Kaplan-Meier survival curves demonstrated no significant differences in cumulative cardiovascular or respiratory morbidity incidence between groups (log rank p = 0.69 and p = 0.10, respectively). Cox regression models reaffirmed a comparable risk for hospitalization between groups (aHR = 0.99 (95% CI 0.85-1.14, p = 0.87) and aHR = 0.97 (95% CI 0.92-1.02, p = 0.28).

CONCLUSIONS

Nuchal cord is not associated with higher rate of perinatal mortality nor long-term cardiorespiratory morbidity.

摘要

目的

评估脐带绕颈儿分娩的围产期及长期心血管和呼吸系统合并症。

研究设计

对单胎分娩进行了一项基于人群的大型队列分析。评估了母体和分娩特征以及心血管和呼吸系统合并症的发生率。采用 Kaplan-Meier 生存曲线比较组间累积住院发生率。采用 Cox 回归模型控制可能的混杂因素和随访时间。

结果

共纳入 243682 例分娩,其中 34332 例(14.1%)诊断为脐带绕颈。两组围产儿死亡率无显著差异(0.5% vs. 0.6%,p=0.16)。Kaplan-Meier 生存曲线显示两组间累积心血管或呼吸系统合并症发生率无显著差异(log rank p=0.69 和 p=0.10,分别)。Cox 回归模型再次证实两组间住院风险相当(aHR=0.99(95%CI 0.85-1.14,p=0.87)和 aHR=0.97(95%CI 0.92-1.02,p=0.28))。

结论

脐带绕颈与围产儿死亡率升高或长期心肺合并症无关。

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