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产程难产结局的新生儿出生体重阈值在矮身材和正常身材女性之间是否存在差异?

Do neonatal birth weight thresholds for labor dystocia outcomes differ between short and normal stature women?

机构信息

Department of Obstetrics and Gynecologye, Meir Medical Center, Kfar Saba, Israel.

Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

出版信息

Int J Gynaecol Obstet. 2024 Sep;166(3):1023-1030. doi: 10.1002/ijgo.15139. Epub 2023 Sep 23.

Abstract

OBJECTIVE

To determine if there is a correlation between maternal short stature and neonatal birth weight among women with adverse outcomes related to labor dystocia.

METHODS

The medical records of singleton deliveries with adverse obstetric outcomes related to labor dystocia during 2014-2020, in a single tertiary center, were reviewed. Outcomes included at least one of the following: cesarean delivery (CD) due to cephalopelvic disproportion (CPD), prolonged second stage, shoulder dystocia, third- or fourth-degree perineal tear. Maternal short stature was defined as height below the 10th centile (short stature group) and normal stature was defined as maternal height between the 10th and 90th centiles (normal stature group). Maternal and neonatal characteristics were compared between the groups.

RESULTS

A total of 3295 women were included, among them, 307 in the short stature group (9.3%, height 1.52 ± 0.02 m) and 2988 in the normal stature group (90.7%, height 1.63 ± 0.04 m). Evaluating the entire cohort revealed similar neonatal birth weights comparing the short and normal stature groups. A subgroup analysis of women after CD due to CPD (n = 296) revealed lower neonatal birth weights in the short stature group (n = 31) compared with the normal stature group (n = 265) (3215 ± 411 vs 3484 ± 427 g, P = 0.001, respectively). Multivariable linear regression was performed for women who underwent CD due to CPD. After adjusting for obesity and diabetes mellitus, short stature and nulliparity were found to be independently associated with decreased neonatal birth weight (266 g less for short stature, P = 0.001, and 294 g less for nulliparity, P = 0.001).

CONCLUSIONS

Among women with short stature, CD due to CPD occurs at lower neonatal birth weights.

摘要

目的

确定在与分娩困难相关的不良结局的女性中,母亲身材矮小与新生儿出生体重之间是否存在相关性。

方法

回顾了 2014 年至 2020 年期间,在一家单一的三级中心,因分娩困难而导致不良产科结局的单胎分娩的病历。结果包括以下至少一项:因头盆不称(CPD)行剖宫产术(CD)、第二产程延长、肩难产、三度或四度会阴撕裂。母亲身材矮小定义为身高低于第 10 百分位数(矮小组),正常身高定义为母亲身高在第 10 百分位至第 90 百分位之间(正常身高组)。比较两组间的产妇和新生儿特征。

结果

共纳入 3295 名女性,其中矮小组 307 名(9.3%,身高 1.52±0.02m),正常身高组 2988 名(90.7%,身高 1.63±0.04m)。评估整个队列发现,矮小组和正常身高组新生儿出生体重相似。在因 CPD 行 CD 的女性亚组分析(n=296)中,矮小组(n=31)新生儿出生体重低于正常身高组(n=265)(3215±411 vs 3484±427g,P=0.001)。对因 CPD 行 CD 的女性进行多元线性回归分析。在调整肥胖和糖尿病后,发现矮小和初产妇与新生儿出生体重降低独立相关(矮小组少 266g,P=0.001,初产妇少 294g,P=0.001)。

结论

在身材矮小的女性中,因 CPD 行 CD 时新生儿出生体重较低。

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