Neonatal morbidity after cesarean section before labor at 34+0 to 38+6 weeks: a cohort study
Neonatal morbidity after cesarean section before labor at 34+0 to 38+6 weeks: a cohort study
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临产前 34 0 至 38 6 周剖宫产后新生儿发病率：一项队列研究
DOI：
10.3109/14767058.2015.1047758
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发表时间：
2016
期刊：
影响因子：
--
通讯作者：
T. Frusca
中科院分区：
文献类型：
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作者：
F. Prefumo;E. Ferrazzi;M. Di Tommaso;F. Severi;A. Locatelli;G. Chirico;C. Dani;G. Lista;R. Orabona;C. Zambolo;T. Frusca
摘要目的：描述分娩前34+0和38+6周之间通过剖宫产（CS）出生的新生儿的发病率，按胎龄分层。方法：队列研究来自五家意大利三级医院。纳入了2010年1月至2011年8月期间在妊娠34+0周和38+6周之间分娩的连续性单胎妊娠。分娩期、胎膜早破或既往使用过类固醇的妇女被排除在外。按孕周计算新生儿并发症的发生率。结果：共分析1135例。新生儿综合不良结局、呼吸窘迫综合征、短暂性呼吸急促和持续气道正压通气的使用从妊娠34周时的50%、28%、5%和22%降至妊娠38周时的4.7%、1.0%、0.9%和0.3%。多变量分析显示，与复合不良新生儿结局独立相关的唯一变量是分娩时的胎龄（校正比值比0.49; 95%置信区间0.39-0.61）。结论：分娩前CS分娩的新生儿并发症的患病率在孕34 ~ 38周的每一周减半。尽管如此，并发症，主要是呼吸系统问题，仍然存在于早期妊娠。
Abstract Objective: To describe morbidity in neonates born by cesarean section (CS) before labor between 34+0 and 38+6 weeks, stratified by gestational age. Methods: Cohort study from five Italian tertiary care hospitals. Consecutive singleton pregnancies delivered by CS before labor between 34+0 and 38+6 weeks of gestation from January 2010 to August 2011 were included. Women in labor, with premature rupture of membranes, or with previous administration of steroids were excluded. The incidence of neonatal complication by gestational week was calculated. Results: A total of 1135 cases were analyzed. Composite adverse neonatal outcomes, respiratory distress syndrome, transient tachypnea and use of continuous airway positive pressure decreased from 50%, 28%, 5% and 22% at 34 weeks of gestation, to 4.7%, 1.0%, 0.9% and 0.3% at 38 weeks of gestation. Multivariate analysis showed that the only variable independently associated with composite adverse neonatal outcome was gestational age at delivery (adjusted odds ratio 0.49; 95% confidence interval 0.39–0.61). Conclusions: The prevalence of neonatal complications in newborns delivered by CS before labor halves at each week of gestation from 34 to 38 weeks. Nonetheless complications, and mainly respiratory problems, are still present at early term gestation.
DOI：
10.1056/nejmoa0803267
发表时间：
2009-01-08
期刊：
The New England journal of medicine
影响因子：
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作者：
Tita AT;Landon MB;Spong CY;Lai Y;Leveno KJ;Varner MW;Moawad AH;Caritis SN;Meis PJ;Wapner RJ;Sorokin Y;Miodovnik M;Carpenter M;Peaceman AM;O'Sullivan MJ;Sibai BM;Langer O;Thorp JM;Ramin SM;Mercer BM;Eunice Kennedy Shriver NICHD Maternal-Fetal Medicine Units Network
通讯作者：
Eunice Kennedy Shriver NICHD Maternal-Fetal Medicine Units Network