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影响剖宫产术双胎妊娠新生儿结局的因素:一项横断面研究。

Factors influencing neonatal outcomes in twin pregnancies undergoing cesarean section: a cross-sectional study.

机构信息

University of Health Sciences, Bursa Yuksek Ihtisas Training and Research Hospital, Department of Anesthesiology and Reanimation - Bursa, Turkey.

University of Health Sciences, Bursa Yuksek Ihtisas Training and Research Hospital, Department of Obstetrics and Gynecology - Bursa, Turkey.

出版信息

Rev Assoc Med Bras (1992). 2023 May 19;69(5):e20221464. doi: 10.1590/1806-9282.20221464. eCollection 2023.

Abstract

OBJECTIVE

This study aimed to evaluate maternal and fetal characteristics and factors affecting fetal outcomes in twin pregnancies delivered by cesarean section.

METHODS

This was a cross-sectional study in a tertiary care referral hospital. The primary outcome was to ascertain the effects of independent factors on the 1st and 5th minute APGAR scores, neonatal intensive care unit admissions, the need for mechanical ventilation, and neonatal mortality.

RESULTS

A total of 453 pregnant women and 906 newborns were included in the analysis. The final logistic regression model revealed that early gestational weeks and neonates <3rd weight percentile at the time of delivery were the most significant predictors of all poor outcome parameters in at least one of the twins (p<0.05). General anesthesia for cesarean section was associated with 1st minute APGAR<7 and the need for mechanical ventilation, and emergency surgery was correlated with the need for mechanical ventilation (p<0.05) in at least one of the twins.

CONCLUSION

General anesthesia, emergency surgery, early gestational weeks, and birth weight <3rd weight percentile were strongly associated with poor neonatal outcomes in at least one of the twins delivered by cesarean section.

摘要

目的

本研究旨在评估行剖宫产术分娩的双胎妊娠的母儿特征及影响胎儿结局的因素。

方法

这是一项在三级保健转诊医院进行的横断面研究。主要结局是确定独立因素对第 1 分钟和第 5 分钟 Apgar 评分、新生儿重症监护病房入院、需要机械通气和新生儿死亡的影响。

结果

共纳入 453 名孕妇和 906 名新生儿。最终的逻辑回归模型显示,孕早期和分娩时新生儿体重<第 3 百分位数是至少有一对双胞胎所有不良结局参数的最重要预测因素(p<0.05)。剖宫产全麻与第 1 分钟 Apgar<7 和需要机械通气有关,紧急手术与至少有一对双胞胎需要机械通气相关(p<0.05)。

结论

全麻、紧急手术、孕早期和出生体重<第 3 百分位数与至少有一对双胞胎行剖宫产术分娩的新生儿不良结局密切相关。

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引用本文的文献

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Comment on "Factors influencing neonatal outcomes in twin pregnancies undergoing cesarean section: a cross-sectional study".
Rev Assoc Med Bras (1992). 2024 Apr 22;70(3):e20231309. doi: 10.1590/1806-9282.20231309. eCollection 2024.

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