Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, 10700, Thailand.
Clinical Epidemiological Unit, Office for Research and Development, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, 10700, Thailand.
Sci Rep. 2024 May 25;14(1):11960. doi: 10.1038/s41598-024-62703-x.
To investigate neonatal injuries, morbidities and risk factors related to vaginal deliveries. This retrospective, descriptive study identified 3500 patients who underwent vaginal delivery between 2020 and 2022. Demographic data, neonatal injuries, complications arising from vaginal delivery and pertinent risk factors were documented. Neonatal injuries and morbidities were prevalent in cases of assisted vacuum delivery, gestational diabetes mellitus class A2 (GDMA2) and pre-eclampsia with severe features. Caput succedaneum and petechiae were observed in 291/3500 cases (8.31%) and 108/3500 cases (3.09%), respectively. Caput succedaneum was associated with multiparity (adjusted odds ratio [AOR] 0.36, 95% confidence interval [CI] 0.22-0.57, P < 0.001) and assisted vacuum delivery (AOR 5.18, 95% CI 2.60-10.3, P < 0.001). Cephalohaematoma was linked to GDMA2 (AOR 11.3, 95% CI 2.96-43.2, P < 0.001) and assisted vacuum delivery (AOR 16.5, 95% CI 6.71-40.5, P < 0.001). Scalp lacerations correlated with assisted vacuum and forceps deliveries (AOR 6.94, 95% CI 1.85-26.1, P < 0.004; and AOR 10.5, 95% CI 1.08-102.2, P < 0.042, respectively). Neonatal morbidities were associated with preterm delivery (AOR 3.49, 95% CI 1.39-8.72, P = 0.008), night-time delivery (AOR 1.32, 95% CI 1.07-1.63, P = 0.009) and low birth weight (AOR 7.52, 95% CI 3.79-14.9, P < 0.001). Neonatal injuries and morbidities were common in assisted vacuum delivery, maternal GDMA2, pre-eclampsia with severe features, preterm delivery and low birth weight. Cephalohaematoma and scalp lacerations were prevalent in assisted vaginal deliveries. Most morbidities occurred at night.Clinical trial registration: Thai Clinical Trials Registry 20220126004.
探讨与阴道分娩相关的新生儿损伤、疾病及危险因素。本回顾性描述性研究纳入了 2020 年至 2022 年间 3500 例行阴道分娩的患者。记录了人口统计学数据、新生儿损伤、阴道分娩相关并发症及相关危险因素。真空辅助分娩、妊娠期糖尿病 A2 级（GDMA2）和重度子痫前期与新生儿损伤和疾病的发生相关。3500 例患者中，有 291 例（8.31%）发生头颅血肿，108 例（3.09%）发生瘀点。头颅血肿与多胎妊娠（调整优势比 [OR] 0.36，95%置信区间 [CI] 0.22-0.57，P<0.001）和真空辅助分娩（OR 5.18，95% CI 2.60-10.3，P<0.001）相关。头颅血肿还与 GDMA2（OR 11.3，95% CI 2.96-43.2，P<0.001）和真空辅助分娩（OR 16.5，95% CI 6.71-40.5，P<0.001）相关。胎头血肿与 GDMA2（OR 11.3，95% CI 2.96-43.2，P<0.001）和真空辅助分娩（OR 16.5，95% CI 6.71-40.5，P<0.001）和真空辅助分娩（OR 16.5，95% CI 6.71-40.5，P<0.001）相关。胎头血肿与 GDMA2（OR 11.3，95% CI 2.96-43.2，P<0.001）和真空辅助分娩（OR 16.5，95% CI 6.71-40.5，P<0.001）相关。头皮裂伤与真空辅助和产钳分娩相关（OR 6.94，95% CI 1.85-26.1，P<0.004；OR 10.5，95% CI 1.08-102.2，P<0.042）。新生儿疾病与早产（OR 3.49，95% CI 1.39-8.72，P=0.008）、夜间分娩（OR 1.32，95% CI 1.07-1.63，P=0.009）和低出生体重（OR 7.52，95% CI 3.79-14.9，P<0.001）相关。新生儿损伤和疾病在真空辅助分娩、母体 GDMA2、重度子痫前期、早产和低出生体重中较为常见。胎头血肿和头皮裂伤在阴道辅助分娩中更为常见。大多数疾病发生在夜间。临床试验注册：泰国临床试验注册处 20220126004。
