体重2000克及以下新生儿真空吸引术导致脑室周围-脑室内出血的风险。

The risk of periventricular-intraventricular hemorrhage with vacuum extraction of neonates weighing 2000 grams or less.

作者信息

Thomas S J, Morgan M A, Asrat T, Weeks J W

机构信息

Department of Obstetrics and Gynecology, University of California, Irvine Orange, USA.

出版信息

J Perinatol. 1997 Jan-Feb;17(1):37-41.

PMID:9069063

Abstract

OBJECTIVE

The objective of this retrospective study was to test the hypothesis that vacuum extraction of neonates with a birth weight < or = 2000 gm is associated with an increased risk of periventricular-intraventricular hemorrhage (PV-IVH).

STUDY DESIGN

One hundred sixty-eight neonates weighing < or = 2000 gm were entered into this case control study. Fifty-six neonates delivered by silicone-rubber vacuum comprised the study group. For every infant born by vacuum-assisted delivery, two spontaneously delivered neonates served as controls (n = 112) and were matched for best obstetric gestational age (within 1 week), delivery date within 1 year, and birth weight < or = 2000 gm. Maternal and neonatal medical records were reviewed for demographic variables, antenatal complications, indication for vacuum-assisted delivery, neonatal birth weight, Apgar scores, umbilical cord blood gas values, and neonatal morbidity including the incidence of PV-IVH. All perinatal outcome variables were compared between the vacuum-assisted and spontaneously delivered groups.

RESULTS

Both groups were similar with regard to maternal age, parity, antepartum complications, gestational age at delivery, neonatal birth weight, and gender. Both groups were also similar with regard to the incidence of 1-minute Apgar score < 5, small for gestational age, cephalhematoma, birth trauma, respiratory distress syndrome, hyperbilirubinemia, and sepsis. There was a significant increased incidence of 5-minute Apgar scores < 7 in the vacuum-assisted group (p = 0.04). No significant difference was observed in the incidence of PV-IVH grades 1 through 4 (21.4% vacuum group vs 16.1% control group, odds ratio 1.42, 0.58 to 3.45).

CONCLUSION

Indicated use of the silicone-rubber vacuum to assist vaginal delivery of neonates weighing < or = 2000 gm does not appear to be associated with an increased risk of PV-IVH or other neonatal complications.

摘要

目的

本回顾性研究的目的是检验以下假设，即出生体重≤2000克的新生儿进行真空吸引与脑室周围-脑室内出血（PV-IVH）风险增加相关。

研究设计

168名体重≤2000克的新生儿纳入本病例对照研究。56名通过硅胶真空吸引分娩的新生儿组成研究组。对于每例真空辅助分娩的婴儿，选取两名自然分娩的新生儿作为对照（n = 112），并根据最佳产科孕周（1周内）、1年内的分娩日期以及出生体重≤2000克进行匹配。回顾产妇和新生儿的医疗记录，以获取人口统计学变量、产前并发症、真空辅助分娩指征、新生儿出生体重、阿氏评分、脐血气值以及包括PV-IVH发病率在内的新生儿发病率。比较真空辅助分娩组和自然分娩组的所有围产期结局变量。

结果

两组在产妇年龄、产次、产前并发症、分娩时孕周、新生儿出生体重和性别方面相似。两组在1分钟阿氏评分<5分、小于胎龄儿、头颅血肿、产伤、呼吸窘迫综合征、高胆红素血症和败血症的发病率方面也相似。真空辅助组5分钟阿氏评分<7分的发病率显著增加（p = 0.04）。在1至4级PV-IVH的发病率方面未观察到显著差异（真空组为21.4%，对照组为16.1%，优势比为1.42，95%可信区间为0.58至3.45）。