Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland.
Department of Pediatrics, Mikkeli Central Hospital, Mikkeli, Finland; Institute of Clinical Medicine and Department of Pediatrics, University of Eastern Finland, Kuopio, Finland.
Eur J Obstet Gynecol Reprod Biol. 2022 Oct;277:77-83. doi: 10.1016/j.ejogrb.2022.08.013. Epub 2022 Aug 24.
There are only few studies on the effects of pelvic or hip fractures on subsequent delivery outcomes. The aim for this study is to evaluate in a nationwide sample whether the rate of elective CS and emergency CS would decrease during the time after maternal hip and pelvic fracture.
In this nationwide registry-based study, data on all women aged 15-49 years with pelvic or hip fractures leading to hospitalization were retrieved from the Care Register for Health Care for the years 1998-2018. Wrist fractures were used as a control group. The data were linked with data from the National Birth Register, where each first pregnancy during the 14-year follow-up is collected. The delivery outcomes of these pregnancies were analyzed. The results were interpreted with odds ratios (OR), adjusted odds ratios (aOR), and 95 % confidence intervals (CI).
A total of 2878 women with pelvic fracture, 1330 women with hip fracture, and 29 580 with wrist fracture found in the Care Register for Health Care. Of these, a total of 586 (20.4 %) women gave birth during the following 14 years after pelvic fracture, 147 (11.0 %) women after hip fracture, and 5255 (17.7 %) women after wrist fracture. Women with pelvic fracture had higher odds for CS during each time period. The aOR for CS was 1.62 (CI 1.22-2.12) during first 5 years, 1.87 (CI 1.33-2.62) during years 5-10, and 1.97 (CI 1.11-3.41) during years 10-14. Women with hip fractures had notably higher odds for CS during first 5 years after fracture (aOR 1.64, CI 1.40-2.67).
The results of this study advocate that vaginal delivery is generally possible rather quickly after hip or pelvic fracture. Unplanned CS after hip fractures was more common at the beginning, but the exact reason for this remains unknown and further research should be made on this topic.
仅有少数研究探讨了骨盆或髋部骨折对后续分娩结局的影响。本研究旨在评估在全国范围内的样本中，女性在发生髋部和骨盆骨折后，其选择性剖宫产（CS）和紧急 CS 的比率是否会随时间下降。
在这项全国范围内基于登记的研究中，从 1998 年至 2018 年的医疗保健患者登记系统中检索了因骨盆或髋部骨折而住院的所有 15-49 岁女性的数据。腕部骨折被用作对照组。这些数据与国家分娩登记处的数据相关联，其中收集了 14 年随访期间的每一次初次妊娠。分析这些妊娠的分娩结局。结果用比值比（OR）、调整比值比（aOR）和 95%置信区间（CI）进行解释。
在医疗保健患者登记系统中发现了 2878 例骨盆骨折、1330 例髋部骨折和 29580 例腕部骨折的女性。其中，共有 586（20.4%）名妇女在骨盆骨折后 14 年内分娩，147（11.0%）名妇女在髋部骨折后分娩，5255（17.7%）名妇女在腕部骨折后分娩。骨盆骨折的女性在每个时间段内剖宫产的几率更高。首次 5 年内 CS 的 aOR 为 1.62（95%CI 1.22-2.12），5-10 年内为 1.87（95%CI 1.33-2.62），10-14 年内为 1.97（95%CI 1.11-3.41）。髋部骨折的女性在骨折后首次 5 年内剖宫产的几率显著更高（aOR 1.64，95%CI 1.40-2.67）。
本研究结果表明，女性在髋部或骨盆骨折后，通常能够较快地进行阴道分娩。髋部骨折后计划外 CS 更为常见，但确切原因尚不清楚，应进一步对此进行研究。
