Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland.
Department of Pediatrics, Mikkeli Central Hospital, Mikkeli, Finland.
PLoS One. 2022 Aug 5;17(8):e0272579. doi: 10.1371/journal.pone.0272579. eCollection 2022.
The incidences of spine fractures and fusion surgeries have increased. A few studies have reported an increased rate of caesarean sections (CS) in women who have undergone spine surgery but have not reported on the health of neonates.
We report the incidence of spine fractures, spine fracture surgeries and fusion surgery for other reasons and the effect of these injuries and procedures on later pregnancy outcomes in Finland.
Data on all fertile-aged women (1998-2018) who had undergone spine fracture or spine fusion surgery were retrieved from the Care Register for Healthcare and combined with data from the National Medical Birth Register. Women with spine fracture or spine surgery before pregnancy were compared with women without previous spine fracture or surgery. We calculated incidences of spine fracture, spine fracture surgery and fusion surgery for other reasons with 95% confidence intervals (CI). We used multivariable logistic regression to evaluate CS and neonatal health. Results are reported as adjusted odds ratios (AOR).
The main finding of our study was the increasing incidence (156%) of spine fusion surgeries for other reasons in fertile-aged women. A total CS rate (including elective and unplanned CS) in the spine fracture group was 19.7% (AOR 1.26, CI 1.17-1.34), in fusion surgery for other reasons group 25.3% (AOR 1.37, CI 1.30-1.49) and 15.9% in the control group. The rate for neonates requiring intensive care in the spine fracture group was 12.2% (AOR 1.18, CI 1.08-1.29), in fusion surgery for other reasons group 13.6% (AOR 1.12, CI 1.02-1.23) and 10.0% in the control group.
The incidence of fusion surgery for other reasons increased during our study period. The rate of CS was higher in women with preceding spine fracture or fusion surgery. Our results suggest that vaginal delivery after fractures of the spine is both possible and safe for mother and neonate.
脊柱骨折和融合手术的发生率有所增加。有几项研究报告称，接受过脊柱手术的女性剖宫产（CS）的比例有所增加，但并未报告新生儿的健康状况。
我们报告了在芬兰脊柱骨折、脊柱骨折手术和其他原因的融合手术的发生率，以及这些损伤和手术对后续妊娠结局的影响。
从医疗保健关怀登记处检索了所有育龄妇女（1998-2018 年）的脊柱骨折或脊柱融合手术数据，并与国家医疗出生登记处的数据相结合。将有脊柱骨折或脊柱手术史的孕妇与无脊柱骨折或手术史的孕妇进行比较。我们计算了脊柱骨折、脊柱骨折手术和其他原因融合手术的发生率，置信区间（CI）为 95%。我们使用多变量逻辑回归来评估 CS 和新生儿健康。结果以调整后的优势比（AOR）表示。
我们研究的主要发现是，育龄妇女脊柱融合手术其他原因的发生率（156%）增加。脊柱骨折组的总 CS 率（包括选择性和非计划性 CS）为 19.7%（AOR 1.26，CI 1.17-1.34），其他原因融合手术组为 25.3%（AOR 1.37，CI 1.30-1.49），对照组为 15.9%。脊柱骨折组需要重症监护的新生儿比例为 12.2%（AOR 1.18，CI 1.08-1.29），其他原因融合手术组为 13.6%（AOR 1.12，CI 1.02-1.23），对照组为 10.0%。
在我们的研究期间，其他原因的融合手术发生率有所增加。有脊柱骨折或融合手术史的女性 CS 率更高。我们的研究结果表明，脊柱骨折后阴道分娩对母婴均是可行且安全的。
