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臀位分娩中的先天性异常:一项全国性的记录链接研究。

Congenital anomalies in breech presentation: A nationwide record linkage study.

机构信息

Department of Obstetrics and Gynecology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.

Information Services Department, Finnish Institute for Health and Welfare (THL), Helsinki, Finland and Karolinska Institute, Department of Neurobiology, Care Sciences and Society, Stockholm, Sweden.

出版信息

Congenit Anom (Kyoto). 2021 Jul;61(4):112-117. doi: 10.1111/cga.12411. Epub 2021 Feb 18.

Abstract

Our study aimed to determine if congenital anomalies are associated with breech presentation at delivery. We conducted a nationwide, retrospective population-based record linkage study and analyzed all singleton births in Finland from 1996 to 2016 using the mandatory health register data collected by the Finnish Institute for Health and Welfare. We compared all major congenital anomalies detected during pregnancy, birth, or the first year of life according to the fetus's presentation at the time of delivery using X -square statistic and Student's t test. We adjusted the results for known risk factors for congenital anomalies to estimate adjusted odds ratios and 95% confidence intervals. Fetuses in breech presentation at delivery had an increased risk for congenital anomalies (6.5%) compared with fetuses in cephalic presentation (3.6%), P < .001. Breech presentation was associated with nearly all types of examined congenital anomalies. The strongest associations were observed with congenital deformities of the hip, the central nervous system, the respiratory system, and the musculoskeletal system. Our study supports the theory that breech presentation is, in many cases, a symptom of a fundamental problem in fetal morphogenesis or function. Neonates born in the breech presentation have a higher risk of congenital anomalies and should undergo a postnatal screening.

摘要

我们的研究旨在确定先天性异常是否与分娩时臀位有关。我们进行了一项全国性的、回顾性的基于人群的记录链接研究,使用芬兰卫生和福利研究所收集的强制性健康登记数据,分析了 1996 年至 2016 年期间芬兰所有的单胎分娩。我们根据分娩时胎儿的体位,使用 X 平方统计和学生 t 检验比较了所有在妊娠、分娩或出生后第一年发现的主要先天性异常。我们对已知的先天性异常危险因素进行了调整,以估计调整后的优势比和 95%置信区间。与头位分娩的胎儿相比,臀位分娩的胎儿发生先天性异常的风险增加(6.5%),P<0.001。臀位与几乎所有类型的检查到的先天性异常都有关。与髋关节、中枢神经系统、呼吸系统和肌肉骨骼系统的先天性畸形相关性最强。我们的研究支持了这样一种理论,即在许多情况下,臀位是胎儿形态发生或功能的根本问题的一种表现。臀位分娩的新生儿发生先天性异常的风险较高,应进行产后筛查。

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