既往剖宫产。前置胎盘的一个危险因素？

Previous cesarean birth. A risk factor for placenta previa?

作者信息

McMahon M J, Li R, Schenck A P, Olshan A F, Royce R A

机构信息

Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill 27599-7570, USA.

出版信息

J Reprod Med. 1997 Jul;42(7):409-12.

PMID:9252931

Abstract

OBJECTIVE

To study the risk of placenta previa following a previous cesarean birth.

STUDY DESIGN

We conducted a population-based, case-control study using 1990 North Carolina state birth certificate data. The study population included 342 women with a pregnancy complicated by placenta previa and 1,082 randomly selected controls. Analysis was restricted to women who reported one or more previous live births and delivered a singleton, live neonate. Adjusted odds ratios (ORs) with 95% confidence intervals (95% CIs) were calculated using logistic regression, controlling for maternal age, race, prior spontaneous or induced abortions and cigarette use.

RESULTS

When the data were adjusted for maternal age, race, prior spontaneous or induced abortions, and cigarette use, women who had a previous cesarean birth and had a parity of 3 were 1.7 times more likely (OR 1.7, 95% CI 0.7, 4.2) and women of parity > or = 4 were 5.5 times more likely (OR 5.5, 95% CI 1.0, 30.1) to have placenta previa than women of parity 1 who had a previous cesarean birth.

CONCLUSION

Women with a history of a previous cesarean birth and parity > or = 3 were at increased risk of having a pregnancy complicated by placenta previa.

摘要

目的

研究既往剖宫产术后前置胎盘的风险。

研究设计

我们利用1990年北卡罗来纳州出生证明数据进行了一项基于人群的病例对照研究。研究人群包括342例妊娠合并前置胎盘的女性和1082例随机选取的对照。分析仅限于报告有一次或多次既往活产且分娩单胎活产新生儿的女性。采用逻辑回归计算调整后的比值比（OR）及95%置信区间（95%CI），并对产妇年龄、种族、既往自然流产或人工流产史及吸烟情况进行控制。

结果

在对产妇年龄、种族、既往自然流产或人工流产史及吸烟情况进行数据调整后，既往有剖宫产史且产次为3的女性发生前置胎盘的可能性是既往有剖宫产史且产次为1的女性的1.7倍（OR 1.7，95%CI 0.7，4.2），产次≥4的女性发生前置胎盘的可能性是其5.5倍（OR 5.5，95%CI 1.0，30.1）。