Vacuum assisted birth and risk for cerebral complications in term newborn infants: a population-based cohort study.
Vacuum assisted birth and risk for cerebral complications in term newborn infants: a population-based cohort study.
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DOI：
10.1186/1471-2393-14-36
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发表时间：
2014-01-20
影响因子：
3.1
通讯作者：
Norman M
中科院分区：
文献类型：
--
作者：
Ekéus C;Högberg U;Norman M
很少有研究集中于真空引产(VE)新生儿的脑部并发症。本研究的目的是确定VE分娩的新生儿发生颅内出血和/或脑功能障碍的风险，并分别与剖宫产(CS)和自然阴道分娩后的风险进行比较。数据来自瑞典国家登记处。在1999年至2010年的人群队列中，包括所有VE(n = 87,150)、CS(75,216)或自然阴道分娩(n = 851,347)分娩后足月分娩的单胎新生儿，我们比较了新生儿颅内出血、创伤性或非创伤性、惊厥或脑病的几率。以自然阴道分娩为参照组，用Logistic回归计算调整后(主要危险因素和适应症)优势比(AOR)。外伤性和非外伤性颅内出血发生率分别为0.8/万和3.8/1000。VE分娩占创伤性和非创伤性病例的58%和31.5%，分别为10倍风险[AOR 10.05(4.67-21.65)]和双倍风险[AOR 2.23(1.57-3.16)]。出生体重高和母亲矮小与风险最高有关。CS分娩的婴儿没有增加颅内出血的风险。在VE和CS分娩的婴儿中，惊厥或脑病的风险相似，比无辅助自然阴道分娩的OR高2至3倍。真空助产会增加新生儿颅内出血的风险。虽然在这项观察性研究中不能确定因果关系，但重要的是要意识到VE分娩中颅内出血的风险增加，特别是在矮小的孕妇和大个子婴儿中。这一结果为辅助阴道分娩的决策和实施提供了进一步的研究。
Few studies have focused on cerebral complications among newborn infants delivered by vacuum extraction (VE). The aim of this study was to determine the risk for intracranial haemorrhage and/or cerebral dysfunction in newborn infants delivered by VE and to compare this risk with that after cesarean section in labour (CS) and spontaneous vaginal delivery, respectively. Data was obtained from Swedish national registers. In a population-based cohort from 1999 to 2010 including all singleton newborn infants delivered at term after onset of labour by VE (n = 87,150), CS (75,216) or spontaneous vaginal delivery (n = 851,347), we compared the odds for neonatal intracranial haemorrhage, traumatic or non-traumatic, convulsions or encephalopathy. Logistic regressions were used to calculate adjusted (for major risk factors and indication) odds ratios (AOR), using spontaneous vaginal delivery as reference group. The rates of traumatic and non-traumatic intracranial hemorrhages were 0.8/10,000 and 3.8/1,000. VE deliveries provided 58% and 31.5% of the traumatic and non-traumatic cases, giving a ten-fold risk [AOR 10.05 (4.67-21.65)] and double risk [AOR 2.23 (1.57-3.16)], respectively. High birth weight and short mother were associated with the highest risks. Infants delivered by CS had no increased risk for intracranial hemorrhages. The risks for convulsions or encephalopathy were similar among infants delivered by VE and CS, exceeding the OR after non-assisted spontaneous vaginal delivery by two-to-three times. Vacuum assisted delivery is associated with increased risk for neonatal intracranial hemorrhages. Although causality could not be established in this observational study, it is important to be aware of the increased risk of intracranial hemorrhages in VE deliveries, particularly in short women and large infants. The results warrant further studies in decision making and conduct of assisted vaginal delivery.
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影响因子：
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作者：
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通讯作者：
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