Nonmedically Indicated Induction of Labor Compared with Expectant Management in Nulliparous Women Aged 35 Years or Older.
Nonmedically Indicated Induction of Labor Compared with Expectant Management in Nulliparous Women Aged 35 Years or Older.
复制标题
35 岁或以上未产妇的非药物引产与期待治疗的比较。
DOI：
10.1055/s-0038-1648228
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发表时间：
2019
影响因子：
2
通讯作者：
Khoury,JaneC
中科院分区：
文献类型：
--
作者：
Kawakita,Tetsuya;Bowers,Katherine;Khoury,JaneC
目的：比较35岁以上非医学指征引产（NMII）与准产的产妇和新生儿结局。研究设计：这是一项回顾性队列研究，研究对象为年龄≥35岁、单胎和足月分娩的头位新生儿。比较在妊娠37、38、39和40周时接受NMII的妇女和当周接受孕妇治疗的妇女的结果。在控制预定义协变量的情况下，计算具有95%置信区间（95% ci）的校正优势比（aORs）。结果3819名年龄≥35岁的产妇中，1409名（36.9%）女性接受了NMII。总体而言，在妊娠39周或更晚，NMII的产妇和新生儿结局相似或改善。在妊娠37、38和39周时，NMII与妊娠37、38和39周剖宫产率降低相关。在妊娠40周时，与预期治疗相比，NMII与阴道手术分娩的几率增加和新生儿重症监护病房（NICU）入院的几率降低有关。结论在≥35岁的未产妇女中，与准产管理相比，NMII与妊娠37 ~ 39周剖宫产率降低和妊娠40周NICU入院率降低相关。
ObjectiveThis article compares maternal and neonatal outcomes in women aged ≥ 35 years who experienced nonmedically indicated induction of labor (NMII) versus expectant management.Study DesignThis was a retrospective cohort study of nulliparas aged ≥ 35 years with a singleton and cephalic presentation who delivered at term. Outcomes were compared between women who underwent NMII at 37, 38, 39, and 40 weeks' gestation and those with expectant management that week. Adjusted odds ratios (aORs) with 95% confidence intervals (95% CIs) were calculated, controlling for predefined covariates.ResultsOf 3,819 nulliparas aged ≥ 35 years, 1,409 (36.9%) women underwent NMII. Overall at 39 weeks' gestation or later, maternal and neonatal outcomes were similar or improved with NMII. At 37, 38, and 39 weeks' gestation, NMII compared with expectant management was associated with decreased odds of cesarean delivery at 37, 38, and 39 weeks' gestation. At 40 weeks' gestation, NMII compared with expectant management was associated with an increased odds of operative vaginal delivery and a decreased odds of neonatal intensive care unit (NICU) admission.ConclusionIn nulliparous women aged ≥ 35 years, NMII was associated with decreased odds of cesarean delivery at 37 to 39 weeks' gestation and decreased odds of NICU admission at 40 weeks' gestation compared with expectant management.