Eshraghi Nasim, Karandish Hadiseh, Mazouri Ali, Abdi Amir, Kashaki Mandana, Bordbar Arash
Vali-E-Asr Reproductive Health Research Center, Family Health Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
Shahid Akbarabadi Clinical Research Development Unit (ShACRDU), School of Medicine, Iran University of Medical Sciences (IUMS), Tehran, Iran.
Arch Gynecol Obstet. 2024 Aug;310(2):705-709. doi: 10.1007/s00404-024-07594-z. Epub 2024 Jun 14.
This study aimed to address the increasing prevalence of cesarean section and the importance of evaluating newborn health through arterial blood gas analysis. Its primary objective was to compare the umbilical cord blood gas levels in newborns delivered through different delivery methods.
This retrospective descriptive cross-sectional study included singleton pregnancies with a gestational age between 37 and 42 weeks and infants weighing between 2500 and 4000 g. Newborns with an Apgar score of 7 or higher at 1 and 5 min were included. Umbilical cord blood samples were collected from each newborn for blood gas analysis within 60 min after birth.
The study included 340 neonates, with 170 born via caesarean section and 170 born through vaginal delivery. No significant differences were observed in Apgar scores between two groups. ABG analysis showed that vaginally born neonates had lower pH (7.24 ± 0.08 vs. 7.27 ± 0.07, P < 0.001), PCO2 (P = 0.015), and HCO3 (P < 0.001). Cesarean section neonates had higher oxygen saturation (P = 0.007) and pressure of oxygen (P < 0.001), and less negative base excess (P < 0.001). In the subgroup analysis, neonates whose mothers received epidural anesthesia had lower pH (7.23 ± 0.07 vs. 7.25 ± 0.08, P = 0.021) and more negative base excess (P = 0.026). Other parameters of ABG did not differ significantly between the groups (P > 0.05).
It has been proven that the mode of delivery, whether it is vaginal or cesarean, as well as the administration of epidural anesthesia during vaginal delivery, have a significant impact on newborns at birth. Newborns delivered vaginally exhibit metabolic acidosis compared to those delivered via cesarean section. Although these differences are statistically significant, they do not have a notable clinical significance, as the average values of the evaluated parameters in both groups fall within the normal range.
本研究旨在应对剖宫产率的不断上升以及通过动脉血气分析评估新生儿健康的重要性。其主要目的是比较不同分娩方式分娩的新生儿的脐血血气水平。
这项回顾性描述性横断面研究纳入了孕周在37至42周之间的单胎妊娠以及体重在2500至4000克之间的婴儿。纳入出生1分钟和5分钟时阿氏评分≥7分的新生儿。在出生后60分钟内从每个新生儿采集脐血样本进行血气分析。
该研究纳入了340例新生儿，其中170例通过剖宫产出生，170例通过阴道分娩出生。两组之间的阿氏评分无显著差异。血气分析显示，阴道分娩的新生儿pH值较低（7.24±0.08 vs. 7.27±0.07，P<0.001）、二氧化碳分压（P=0.015）和碳酸氢根（P<0.001）。剖宫产新生儿的氧饱和度（P=0.007）和氧分压（P<0.001）较高，碱剩余负值较小（P<0.001）。在亚组分析中，母亲接受硬膜外麻醉的新生儿pH值较低（7.23±0.07 vs. 7.25±0.08，P=0.021），碱剩余负值更大（P=0.026）。两组之间血气分析的其他参数无显著差异（P>0.05）。
已证实分娩方式，无论是阴道分娩还是剖宫产，以及阴道分娩期间硬膜外麻醉的使用，对出生时的新生儿均有显著影响。与剖宫产出生的新生儿相比，阴道分娩的新生儿表现出代谢性酸中毒。尽管这些差异具有统计学意义，但它们没有显著的临床意义，因为两组评估参数的平均值均在正常范围内。
