选择性剖宫产对新生儿近远期的影响

Impact of elective cesarean section on short-long term prognosis in neonates

剖宫产手术技术的日臻完善、临床上对剖宫产手术指征的放宽以及对剖宫产术对新生儿不利影响的认识不足，都在一定程度上促使了剖宫产率的大幅上升。该文围绕选择性剖宫产手术对新生儿近期及远期的影响，分析其与新生儿呼吸系统疾病、医源性早产、免疫系统建立以及特异反应性疾病等之间的联系。目前认为，剖宫产手术虽不能作为独立危险因素存在，但可与其他因素产生协同作用，增加新生儿的病死率。所以，临床上应严格掌握手术指征，降低无手术指征的选择性剖宫产率。

The rates of cesarean delivery are dramatically rising in many parts of the world due to the improved surgical techniques and broaden clinical indications, along with the inadequate recognition of potential disadvantages for neonates. This review is to investigate the short-term and long-term influence of elective cesarean section on neonatal outcomes, including neonatal respiratory morbidity, iatrogenic prematurity, postnatal development of the immune system and atopic disease. Althongh there is no evidence that cesarean section is an independent risk factor so far, present studies clearly demonstrate that it plays an important role concurrent with other factors in increasing neonatal morbidity and mortality. Consequently, efforts should be made to reduce high rate of elective cesarean sections through elaborate investigation of medical indications before the operation.