择期剖宫产与阴式分娩对新生儿预后的影响研究

Effect of elective cesarean section and vaginal delivery on the neonatal prognosis

目的研究择期剖宫产与阴式分娩对新生儿预后的影响。方法选择本院产科出生的204例新生儿,按照分娩方式将其分为择期剖宫产组与阴式分娩组,比较两组新生儿的Apgar评分、NBNA评分及免疫指标。结果择期剖宫产组新生儿1分钟、5分钟Apgar评分分别为(9.92±0.25)分、(9.93±0.34)分,阴式分娩组新生儿1分钟、5分钟Apgar评分分别为(9.83±0.43)分、(9.94±0.27)分,两组新生儿1分钟、5分钟Apgar评分比较无显著性差异(P>0.05)。择期剖宫产组新生儿NBNA评分的基础分、加分、转头次数、头竖立时间、踏步反射步数与阴式分娩组新生儿比较差异无显著性(P>0.05)。在同性别新生儿中,择期剖宫产组新生儿C反应蛋白、免疫球蛋白A(IgA)明显高于阴式分娩组,免疫球蛋白G(IgG)、免疫球蛋白M(IgM)明显低于阴式分娩组,组间比较存在显著性差异(P<0.05)。择期剖宫产组男性新生儿IgG水平明显高于女性新生儿,而IgM、IgA水平明显低于女性新生儿(P<0.05)。结论择期剖宫产与阴式分娩两种分娩方式对新生儿Apgar评分及NBNA评分的影响无明显差异,但择期剖宫产会降低新生儿的免疫功能,增加患病机会。

ObjectiveTo study the effects of elective cesarean section and vaginal delivery on neonatal prognosis.Methods204 cases of newborn were selected, they were divided into two groups, the elective cesarean section group or vaginal delivery group according to the mode of delivery, neonatal Apgar score of two groups, NBNA score and the immune index.ResultsThe elective cesarean section group in 1 min, 5 min Apgar scores were （9.92±0.25）, （9.93±0.34）, vaginal delivery group （9.83±0.43）, （9.94±0.27）, 1 min, 5 min and Apgar among two groups was no signiifcant difference （P〉0.05）. Basic elective cesarean section group neonatal NBNA score points, bonus, head, head erect, the number of time stepping reflex steps and vaginal delivery groups there was no signiifcant difference （P〉0.05）. In gender in newborns, elective cesarean section group neonatal C-reactive protein, IgA was signiifcantly higher than that in vaginal delivery group, IgG, IgM was signiifcantly lower than that in vaginal delivery group, there was signiifcant difference between groups （P〈0.05）. Elective cesarean section group of male neonatal IgG level was signiifcantly higher than that in female, while IgM, IgA was signiifcantly lower than that of the female （P〈0.05）.ConclusionIn conclusion, there is no signiifcant difference in elective cesarean section and vaginal delivery in two kinds of mode of delivery on neonatal Apgar score and NBNA score, but selective cesarean section can reduce immune function of neonates, increased chance of illness.