Maternal outcomes associated with planned primary cesarean births compared with planned vaginal births
Maternal outcomes associated with planned primary cesarean births compared with planned vaginal births
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DOI：
10.1097/01.aog.0000255668.20639.40
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发表时间：
2007-03-01
影响因子：
7.2
通讯作者：
Heffner, Linda J.
中科院分区：
文献类型：
--
作者：
Declercq, Eugene;Barger, Mary;Heffner, Linda J.
目的：比较无分娩（计划剖宫产）与阴道分娩和有分娩（计划阴道分娩）的原发性剖宫产的结局和成本。方法：对1998年至2003年期间470,857例出生证明、胎儿死亡记录和与出生相关的出院记录的马萨诸塞州数据系统进行分析。我们研究了244,088名没有剖宫产史和产前风险记录的母亲。然后，我们将母亲分为两组：一组没有分娩并进行了首次剖宫产（计划中的首次剖宫产——3334名妇女），另一组有分娩并进行了阴道分娩或剖宫产（计划中的阴道分娩——240754名妇女）。我们比较了产妇再住院率，并分析了费用和住院时间。结果：计划剖宫产（19.2 / 1000）比计划阴道分娩（7.5 / 1000）在分娩后30天再次住院的可能性更大。在控制了年龄、胎次和种族或民族因素后，计划进行初次剖宫产的母亲在产后30天内再次住院的可能性是2.3倍（95%可信区间[CI] 1.74-2.9）。计划剖宫产术后再住院的主要原因是伤口并发症（6.6 / 1000）
OBJECTIVE: To compare the outcomes and costs associated with primary cesarean births with no labor (planned cesareans) to vaginal and cesarean births with labor (planned vaginal).METHODS: Analysis was based on a Massachusetts data system linking 470,857 birth certificates, fetal death records, and birth-related hospital discharge records from 1998 and 2003. We examined a subset of 244,088 mothers with no prior cesarean and no documented prenatal risk. We then divided mothers into two groups: those with no labor and a primary cesarean (planned primary cesarean deliveries - 3,334 women) and those with labor and either a vaginal birth or a cesarean delivery (planned vaginal-240,754 women). We compared maternal rehospitalization rates and analyzed costs and length of stay.RESULTS: Rehospitalizations in the first 30 days after giving birth were more likely in planned cesarean (19.2 in 1,000) when compared with planned vaginal births (7.5 in 1,000). After controlling for age, parity, and race or ethnicity, mothers with a planned primary cesarean were 2.3 (95% confidence interval [CI] 1.74-2.9) times more likely to require a rehospitalization in the first 30 days postpartum. The leading causes of rehospitalization after a planned cesarean were wound complications (6.6 in 1,000) (P