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择期剖宫产术前子宫收缩与新生儿短暂性气促的关系:一项回顾性队列研究。

Association between uterine contractions before elective caesarean section and transient tachypnoea of the newborn: a retrospective cohort study.

机构信息

Obstetrics and Gynecology, Kofu National Hospital, Kofu, Japan

Obstetrics and Gynecology, Kofu National Hospital, Kofu, Japan.

出版信息

BMJ Open. 2020 Mar 16;10(3):e033154. doi: 10.1136/bmjopen-2019-033154.

Abstract

OBJECTIVE

We evaluated the association between the presence of predelivery uterine contractions and transient tachypnoea of the newborn (TTN) in women undergoing an elective caesarean section.

DESIGN

A retrospective cohort study.

SETTING

National Hospital Organization Kofu National Hospital, which is a community hospital, between January 2011 and May 2019.

PARTICIPANTS

The study included 464 women who underwent elective caesarean section. The exclusion criteria were missing data, twin pregnancy, neonatal asphyxia, general anaesthesia and elective caesarean section before term.

PRIMARY AND SECONDARY OUTCOME MEASURES

Patients were grouped according to the presence or absence of uterine contractions on a 40-min cardiotocogram (CTG) performed within 6 hours before caesarean delivery. We performed a multivariable logistic regression analysis to examine the association between predelivery uterine contractions and TTN.

RESULTS

The incidence of TTN was 9.9% (46/464), and 38.4% (178/464) of patients had no uterine contraction. The absence of uterine contractions was significantly associated with an increased risk of TTN (adjusted OR 2.04; 95% CI 1.09 to 3.82) after controlling for gestational diabetes mellitus, small for gestational age, male sex and caesarean section at 37 weeks.

CONCLUSIONS

Accurate risk stratification using a CTG could assist in the management of infants who are at risk of developing TTN.

摘要

目的

评估择期剖宫产产妇分娩前子宫收缩与新生儿短暂性呼吸急促(TTN)的关系。

设计

回顾性队列研究。

地点

国立医院组织甲府国立医院,这是一家社区医院,时间为 2011 年 1 月至 2019 年 5 月。

参与者

本研究纳入了 464 例行择期剖宫产的产妇。排除标准为数据缺失、双胎妊娠、新生儿窒息、全身麻醉和早产择期剖宫产。

主要和次要结局测量

根据剖宫产前 6 小时内进行的 40 分钟胎心监护(CTG)上是否存在子宫收缩,将患者分为两组。我们进行了多变量逻辑回归分析,以检查分娩前子宫收缩与 TTN 之间的关系。

结果

TTN 的发生率为 9.9%(46/464),464 例患者中有 38.4%(178/464)无子宫收缩。在控制了妊娠期糖尿病、胎儿生长受限、男性和 37 周剖宫产等因素后,无子宫收缩与 TTN 风险增加显著相关(校正 OR 2.04;95% CI 1.09 至 3.82)。

结论

使用 CTG 进行准确的风险分层有助于管理有发生 TTN 风险的婴儿。

相似文献

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Epinephrine for transient tachypnea of the newborn.肾上腺素用于新生儿短暂性呼吸急促。
Cochrane Database Syst Rev. 2016 May 23;2016(5):CD011877. doi: 10.1002/14651858.CD011877.pub2.
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Newborn Respiratory Distress.新生儿呼吸窘迫
Am Fam Physician. 2015 Dec 1;92(11):994-1002.

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