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剖宫产分娩与新生儿疾病发生关联的研究 被引量:7

Correlation Between Cesarean Section and Neonatal Diseases
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摘要 目的探讨剖宫产分娩与新生儿疾病发生是否存在关联,为预防新生儿疾病的发生和降低剖宫产率提供依据。方法通过病历管理系统,选择2004年1月—2013年12月在温州医科大学附属第一医院产科住院分娩的产妇及其新生儿为研究对象,采用病例对照的研究方法,以患有某种新生儿疾病的新生儿为病例组,不患有该种疾病的新生儿为对照组,比较两组剖宫产率是否存在差异。分析时采用多因素Logistic回归分析调整产妇年龄、新生儿性别、剖宫产指征等因素对两者关联的影响。结果 59.3%(2 035/3 432)的产妇分娩方式为剖宫产,54.7%(1 876例)的产妇具有剖宫产指征;40.7%(1 397例)的产妇为阴道分娩。阴道分娩者和剖宫产者年龄、入院待产时间、是否实施抢救、剖宫产指征、住院时间、分娩总费用、分娩护理费用比较,差异均有统计学意义(P<0.01);两者新生儿性别比较,差异无统计学意义(P=0.05)。Logistic回归分析结果显示,新生儿肺部疾病〔OR=1.48,95%CI(1.03,2.11),P=0.03〕、新生儿窒息〔OR=0.37,95%CI(0.29,0.47),P<0.01〕、低体质量儿〔OR=1.56,95%CI(1.09,2.23),P=0.02〕、早产儿〔OR=2.21,95%CI(1.97,2.61),P<0.01〕和低体质量早产儿〔OR=3.00,95%CI(1.98,4.56),P<0.01〕与剖宫产分娩存在关联,而新生儿消化系统疾病〔OR=1.64,95%CI(0.83,3.24),P=0.16〕和新生儿败血症〔OR=0.69,95%CI(0.91,3.69),P=0.28〕与剖宫产分娩无关。结论剖宫产分娩可能增加新生儿罹患呼吸系统疾病的风险,降低新生儿窒息的发生,而与消化系统疾病发生无关。低体质量儿、早产儿和低体质量早产儿更容易选择剖宫产,增加剖宫产率。 Objective To investigate whether correlation exists between cesarean section and neonatal diseases,in order to provide references for the prevention of neonatal diseases and the reduction of cesarean section rate. Methods With the aid of case management system, we enrolled the lying-in women who had child delivery in the First Affiliated Hospital of Wenzhou Medical University from January 2004 to December 2013 and the newborns. Using case-control research method,we assigned newborns that had neonatal disease as case group and newborns that didn' t have any neonatal disease as control group.Comparison was made in cesarean section rate between the two groups. Multivariate Logistic analysis was made to adjust the influence of lying-in women' s age,newborns' gender and cesarean section indication on the correlation between cesarean section and neonatal diseases. Results The cesarean section rate was 59. 3%( 2 035 /3 432),54. 7%( 1 876) had cesarean section indication; the ratio of vaginal delivery was 40. 7%( 1 397). The subjects undergoing vaginal delivery and the subjects undergoing cesarean section were significantly different( P〈0. 01) in age,expectancy time,receiving salvage or not,cesarean section indication,hospitalization time, the total cost of delivery and the cost of delivery nursing and were not significantly different in newborns' gender( P = 0. 05). Logistic regression analysis showed that pulmonary diseases in newborns 〔OR =1. 48,95% CI( 1. 03,2. 11),P = 0. 03〕,neonatal asphyxia 〔OR = 0. 37,95% CI( 0. 29,0. 47),P〈0. 01 〕,low birthweight 〔OR = 1. 56,95% CI( 1. 09,2. 23), P = 0. 02 〕, premature infants 〔OR = 2. 21,95% CI( 1. 97,2. 61), P〈0. 01〕 and premature infants with low birth weight 〔OR = 3. 00,95% CI( 1. 98,4. 56), P〈0. 01 〕had correlation with cesarean section, while neonatal digestive system diseases 〔OR = 1. 64,95% CI( 0. 83,3. 24), P = 0. 16 〕 and neonatal septicemia 〔OR = 0. 69,95% CI( 0. 91,3. 69),P = 0. 28〕 had no correlation with cesarean section. Conclusion Cesarean section may increase the risk of respiratory system diseases, decrease the risk of neonatal asphyxia in newborns and have no correlation with digestive system diseases. Low birth weight,premature infants and premature infants with low birth weight may lead to cesarean section,thus increasing cesarean section rate.
出处 《中国全科医学》 CAS CSCD 北大核心 2015年第29期3570-3573,共4页 Chinese General Practice
基金 国家自然科学基金资助项目(81402689)
关键词 剖宫产术 新生儿疾病 病例对照研究 Cesarean section Neonatal diseases Case-control studies
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  • 1Hamilton BE, Martin JA, Ventura SJ. Births: preliminary data for 2006 [J]. Natl Vital Stat Rep, 2007, 56 (7) : 1 -18.
  • 2Lumbiganon P, Laopaiboon M, Gtilmezoglu AM, et al. Method of delivery and pregnancy outcomes in Asia: the WHO global survey on maternal and perinatal health 2007 - 08 [ J]. Lancet, 2010, 375 (9713) : 490-499.
  • 3Habib AS. A review of the impact of phenylephrine administration on maternal hemodynamics and maternal and neonatal outcomes in women undergoing cesarean delivery under spinal anesthesia [ J ]. Anesth Analg, 2012, 114 (2): 377-390.
  • 4Guise JM, Eden K, Emeis C, et al. Vaginal Birth After Cesarean: New Insights [ R]. Rockville, MD: Agency for Heahhcare Research and Quality, 2010.
  • 5Fawsitt CG, Bourke J, Greene RA, et al. At what price? A cost - effectiveness analysis comparing trial of labour after previous caesarean versus elective repeat caesarean delivery [J]. PLoS One, 2013, 8 (3) : e58577.
  • 6梁红,周利锋,王炳顺,钟烨,朱丽萍,高尔生.剖宫产分娩对婴儿健康影响的前瞻性研究[J].生殖与避孕,2007,27(2):124-127. 被引量:14
  • 7周丛乐.剖宫产对新生儿的近远期影响[J].中华围产医学杂志,2008,11(4):232-234. 被引量:9
  • 8Tita AT, Landon MB, Spong CY, et al. Timing of elective repeat cesarean delivery at term and neonatal outcomes [ J ]. N Engl J Med, 2009, 360 (2): 111-120.
  • 9Bager P, Wohlfahrt J, Westergaard T. Caesarean delivery and risk of atopy and allergic disease : meta - analyses [ J ]. Clin Exp Allergy, 2008, 38 (4): 634-642.
  • 10洪海洁,王谢桐.足月选择性剖宫产时机与新生儿呼吸系统疾病的相关性分析[J].实用妇产科杂志,2012,28(4):270-274. 被引量:28

二级参考文献36

  • 1应豪,段涛.剖宫产后再次妊娠的流行病学调查[J].实用妇产科杂志,2004,20(5):260-261. 被引量:173
  • 2王志杰.剖宫产对新生儿的影响[J].实用妇产科杂志,1996,12(1):13-14. 被引量:60
  • 3MacDorman MF, Declercq E, Menacker F, et al. Infant and neonatal mortality for primary cesarean and vaginal births to women with "no indicated risk" United States, 1998-2001 birth cohorts. Birth, 2006,33 : 175 -182.
  • 4Macdorman MF, Declercq E, Menacker F, et al. Neonatal mortality for primary cesarean and vaginal births to low-risk women.-application of an "intention-to-treat" model. Birth, 2008,35:3-8.
  • 5Cai WW, Marks JS,Chen CH, et al. Increased cesarean section rates and emerging patterns of health insurance in Shanghai, China. Am J Public Health,1998,88:777-780.
  • 6Chang JH, Hsu CY, Lo JC, et al. Comparative analysis of neonatal morbidity for vaginal and caesarean section deliveries using hospital charge. Acta Paediatr,2006,95:1561-1566.
  • 7Levine EM, Ghai V, Barton JJ, et al. Mode of delivery and risk of respiratory diseases in newborns. Obstet Gyneeol, 2001,97:439-442.
  • 8Doherty EG, Eiehenwald EC. Cesarean delivery: Emphasis on the neonate. Clin Obstet Gynecol, 2004,47:332-341.
  • 9Hernandez Diaz S, Van Marter LJ, Werler MM, et al. Risk factors for persistent pulmonary hypertension of the newhorn. Pediatrics,2007,120 : e272-e278.
  • 10Hansen AK, Wisborg K, Uldbjerg N, et al, Risk of respiratory morbidity in term infants delivered by elective caesarean section:cohort study, BMJ,2008,336:85-87

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