Brief Report: Cesarean Delivery and Subsequent Fecundability.
Brief Report: Cesarean Delivery and Subsequent Fecundability.
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DOI：
10.1097/ede.0000000000000553
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发表时间：
2016-11
期刊：
影响因子：
--
通讯作者：
Wise LA
中科院分区：
文献类型：
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作者：
Radin RG;Mikkelsen EM;Rothman KJ;Hatch EE;Sorensen HT;Riis AH;Kuohung W;Wise LA
研究表明，与阴道分娩相比，剖宫产与较少的后续分娩有关，但尚不清楚是否与怀孕意图或手术指征相混淆可以解释这些结果。我们评估了910例单胎活产的初产妇剖宫产与随后的生育能力之间的关系。在一组计划怀孕的丹麦妇女（2007-2012）中，通过登记联系获得了产科史；通过问卷调查收集妊娠时间和协变量数据。针对潜在的混杂因素调整了受精率（FR）和95%置信区间（CI）。与自然阴道分娩相比，紧急剖宫产头位分娩与受孕率的相关性较小（FR=1.0, 95% CI: 0.83, 1.3），但剖宫产臀位分娩（FR=0.72, 95% CI: 0.53, 0.97）和计划剖宫产头位分娩（FR=0.51, 95% CI: 0.25, 1.0）与受孕率降低相关。剖宫产与生育能力的关系因先前胎儿的出现和紧急情况而异。
Studies have shown that cesarean delivery is associated with fewer subsequent births relative to vaginal delivery, but it is unclear whether confounding by pregnancy intention or indication for surgery explained these results. We evaluated the association between cesarean delivery and subsequent fecundability among 910 primiparous women after singleton live birth. In a cohort of Danish women planning pregnancy (2007-2012), obstetrical history was obtained via registry linkage; time-to-pregnancy and covariate data were collected via questionnaire. Fecundability ratios (FR) and 95% confidence intervals (CI) were adjusted for potential confounders. Relative to spontaneous vaginal delivery, emergency cesarean delivery with cephalic presentation showed little association with fecundability (FR=1.0, 95% CI: 0.83, 1.3, but cesarean delivery with breech presentation (FR=0.72, 95% CI: 0.53, 0.97) and planned cesarean delivery with cephalic presentation (FR=0.51, 95% CI: 0.25, 1.0) were associated with reduced fecundability. The cesarean-fecundability association varied by previous fetal presentation and emergency status.