Does cesarean delivery prevent cerebral palsy or other neurologic problems of childhood?
Does cesarean delivery prevent cerebral palsy or other neurologic problems of childhood?
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剖腹产能否预防脑瘫或其他儿童神经系统问题？
DOI：
10.1097/00006250-199404000-00025
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发表时间：
1994
影响因子：
7.2
通讯作者：
K. Nelson
中科院分区：
文献类型：
--
作者：
J. Scheller;K. Nelson
目的：探讨剖宫产是否能减少儿童神经系统疾病的发生。数据来源：我们回顾了1969年至1993年间发表的英文文章，通过MEDLINE搜索标题“分娩，腹部”获得。还检索了有关脑瘫和其他儿童神经系统疾病的书籍章节和文章的参考书目。研究方法选择：我们寻找有关阴道分娩与剖宫产分娩以及以下结局的文章：脑瘫、神经发育异常、新生儿癫痫发作和新生儿脑室内出血。十项相关研究被确定，其中只有四项是前瞻性的，其中只有一项（涉及臀位分娩）是随机试验。资料提取与综合：没有研究发现经阴道或剖宫产出生的儿童在脑瘫、神经发育异常和新生儿癫痫发作的发生率上有显著差异。通过剖宫产出生的脊髓脊膜膨出婴儿的残疾严重程度较低。通过剖宫产出生的婴儿患新生儿臂丛神经麻痹的风险降低。患有人类免疫缺陷病毒（HIV）或生殖器病变且无疱疹史的母亲剖宫产可能对婴儿有益。结论：剖宫产可降低脊髓脊膜膨出患儿儿童神经系统不良预后的风险，并可降低臂丛神经麻痹、新生儿疱疹和HIV感染率。然而，经剖宫产出生的儿童患其他儿童神经系统问题或脑瘫的风险并没有降低的记录。（妇产科，1994;83:624‐30）
Objective: To determine whether cesarean delivery can lead to fewer childhood neurologic problems. Data sources: We reviewed English language articles published between 1969 and 1993, obtained via MEDLINE search of the heading “delivery, abdominal.” Bibliographies of book chapters and articles about cerebral palsy and other childhood neurologic disorders were also searched. Methods of study selection: We sought articles that dealt with vaginal versus cesarean delivery and the following outcomes: cerebral palsy, abnormal neurologic development, neonatal seizures, and neonatal intraventricular hemorrhage. Ten relevant studies were identified, only four of which were prospective, and only one of which (involving breech births) was a randomized trial. Data extraction and synthesis: No study found a significant difference in the rates of cerebral palsy, abnormal neurologic development, and neonatal seizures between those children born vaginally or by cesarean. The severity of handicap of infants born with myelomeningocele was less in those delivered via cesarean. Infants born by cesarean had a decreased risk for developing neonatal brachial plexus palsy. Cesarean delivery of mothers with human immunodeficiency virus (HIV) or with genital lesions and no history of herpes may benefit the infant. Conclusions: Cesarean delivery can reduce the risk of adverse childhood neurologic outcome for those born with myelomeningocele, and may reduce the rate of brachial plexus palsies and neonatal herpes and HIV infections. However, children born by cesarean have no documented reduced risk of other childhood neurologic problems or cerebral palsy. (Obstet Gynecol 1994;83:624‐30)