Burt R D, Vaughan T L, Daling J R
Department of Epidemiology, University of Washington, Seattle 98195.
Am J Public Health. 1988 Oct;78(10):1312-4. doi: 10.2105/ajph.78.10.1312.
Data from Washington State birth certificates from 1980-83 were used to estimate excess risk to the infant delivered via repeat cesarean section independently of any risk associated with the indication for the procedure. Using a case-control design, we compared the method of delivery of all infants with low (0-6) five-minute Apgar scores born to multiparous mothers after uncomplicated pregnancies and births to that of similar infants with a high score (7-10), frequency matched by birthweight. Of the 1,030 infants with low Apgar score, 127 (12.3 per cent) were delivered via repeat cesarean section, in contrast to 98 (9.8 per cent) of 998 controls with high Apgar score. In a regression model controlling for birthweight, gestational length, maternal age, and income the relative risk was 1.29 (95% confidence interval 0.97, 1.72). Excess risk was highest among babies of normal (2500-4000 grams) birthweight. While a number of limitations inherent in the source of data require cautious interpretation of these results, we conclude that some excess risk of low Apgar score may be associated with repeat cesarean section procedures.
1980 - 1983年华盛顿州出生证明的数据被用于独立于与剖宫产指征相关的任何风险来估计经重复剖宫产分娩的婴儿的额外风险。采用病例对照设计，我们将所有在无并发症的妊娠和分娩后出生的经产妇所生的五分钟阿氏评分低（0 - 6分）的婴儿的分娩方式与类似的阿氏评分高（7 - 10分）的婴儿的分娩方式进行了比较，并按出生体重进行频率匹配。在1030名阿氏评分低的婴儿中，127名（12.3%）是经重复剖宫产分娩的，相比之下，998名阿氏评分高的对照组婴儿中有98名（9.8%）。在一个控制了出生体重、孕周、产妇年龄和收入的回归模型中，相对风险为1.29（95%置信区间0.97, 1.72）。正常出生体重（2500 - 4000克）的婴儿中额外风险最高。虽然数据来源中存在一些固有限制需要对这些结果进行谨慎解读，但我们得出结论，低阿氏评分的一些额外风险可能与重复剖宫产手术有关。
