足月妊娠分娩方式对再妊娠分娩早产的影响

Influence of delivery mode of the women with full-term pregnancy on their preterm delivery of the subsequent pregnancy

目的:探讨足月妊娠分娩方式对妇女再次妊娠分娩早产(PTB)的影响。方法:应用回顾性研究方法,对2018年2月-2021年4月在河南省南阳市卧龙区妇幼保健院、郑州大学第三附属医院住院分娩二胎(单胎)妇女,根据分娩结局分为足月分娩组、自然早产(sPTB)组、治疗性PTB组,比较分析3组临床资料,应用logisitic回归分析初次足月妊娠分娩方式对妇女再次妊娠分娩sPTB和治疗性PTB的影响。结果:初次分娩宫口扩张10cm时紧急剖宫产(OR=2.062,95%CI 1.405~3.026)是妇女二胎分娩sPTB的危险因素。初次分娩择期剖宫产(OR=2.308,95%CI 1.266~4.208)、初次分娩宫口扩张<4cm时紧急剖宫产(OR=4.683,95%CI 0.990~11.022)、初次分娩宫口扩张4~9cm时紧急剖宫产(OR=2.432,95%CI 1.206~4.906)是妇女二胎分娩治疗性PTB的危险因素。结论:初次分娩宫口扩张10cm时紧急剖宫产与再妊娠分娩sPTB有关;初次分娩择期剖宫产、初次分娩宫口扩张<4cm时紧急剖宫产、初次分娩宫口扩张4~9cm时紧急剖宫与再分娩治疗性PTB有关。

Objective: To explore the influence of delivery mode of the women with full-term pregnancy on their spontaneous preterm birth(sPTB) of the next pregnancy. Methods: A retrospective study was conducted on the singleton women who had delivered their second child from February 2018 to April 2021 were divided into group A, group B(women with sPTB), and group C(women with therapeutic preterm birth) according to their delivery outcomes. The clinical data of the women were compared among the three groups. Logisitic regression was used to analyze the influence of delivery mode of the women with full-term pregnancy on the sPTB and the therapeutic preterm birth of the women during the next pregnancy. Results: The emergency cesarean section when the cervix uteri dilated to 10 cm of the primipara(OR=2.062, 95%CI 1.405-3.026) was a risk factor of their sPTB during the second pregnancy. The selective cesarean section(OR=2.308, 95%CI 1.266-4.208), the emergency cesarean section when the cervix uteri dilated <4 cm(OR=4.683, 95%CI 990-11.022), and the emergency cesarean section when the cervix uteri dilated 4-9 cm(OR=2.432, 95%CI 1.206-4.906) of the primipara were the risk factors of their therapeutic therapeutic preterm birth during the second pregnancy. Conclusion: Emergency cesarean section when the cervix uteri dilated to 10 cm of the primipara is related to their sPTB during the second pregnancy and delivery. The selective cesarean section, the emergency cesarean section when the cervix uteri dilated <4 cm, and the emergency cesarean section when the cervix uteri dilated 4-9 cm of the primipara are related to their therapeutic therapeutic preterm birth during the second pregnancy.