权益分类	功能权益	普通用户	{{item.name}}会员
{{category.name}}	{{benefitItem.name}}

Mode of First Delivery and Subsequent Child-Bearing

首次分娩和随后生育的方式

基本信息

批准号：
8227937
负责人：
Kristen Hawthorne Kjerulff
金额：
$ 63.42万
依托单位：
PENNSYLVANIA STATE UNIV HERSHEY MED CTR
依托单位国家：
美国
项目类别：
财政年份：
2008
资助国家：
美国
起止时间：
2008-05-01 至 2014-02-28
项目状态：
已结题

项目摘要

Project summary/abstract Previous studies, conducted both in the US and other countries, have found that women who deliver their first child by cesarean section are less likely to bear subsequent children and bear fewer subsequent children than women who deliver their first child vaginally. However, nearly all of these studies were retrospective analyses of existing data sets, or surveys of women years after their first delivery. Consequently, it is not clear if women who deliver their first child via cesarean section are different from women who deliver vaginally prior to the first delivery in ways that both predispose them to require delivery by cesarean section and to be less likely to want to or be able to conceive and bear one or more subsequent children, or if there is something about the cesarean section itself that affects women's desire or ability to conceive or bear subsequent children. Given the recent increase in the rate of cesarean section in the US and in countries throughout the world, it is essential that well-designed, carefully conducted, prospective, longitudinal studies with adequate statistical power be conducted to improve scientific knowledge of the extent to which cesarean section increases a woman's risk of subsequent infertility, and if so, why. This prospective, longitudinal study of child-bearing patterns in relation to mode of first delivery is an investigation of both factors that increase a woman's risk of delivering her first child by cesarean section, and the effects of primary cesarean delivery on important outcomes, including subsequent child-bearing. The specific aims of this study are: 1.) To measure pre-first delivery child-bearing desires and intentions among a diverse sample of 2790 pregnant women through interviews designed to assess pre-delivery factors that could explain post-cesarean deficits in subsequent child-bearing, 2.) To measure labor and delivery related factors in the hospital medical records of these 2790 women that could explain post-cesarean deficits in subsequent child-bearing, and 3.) To determine the effects of primary cesarean delivery on subsequent childbearing, via a 3-year prospective, longitudinal study of these 2790 women, with assessments at 1, 6, 12, 18, 24, 30 and 36 months post first delivery, comparing those who deliver by cesarean section to those who deliver vaginally, taking into account factors measured in the pre- delivery interview and the hospital medical records. Project Narrative The rate of cesarean delivery in the US has increased dramatically in the past decade and more than a million women deliver by cesarean section annually. This study will investigate the extent to which cesarean delivery increases a woman's risk of subsequent infertility and will substantially improve the current level of scientific knowledge about this issue.

项目概要/摘要此前在美国和其他国家进行的研究发现，第一次分娩的女性剖腹产的孩子生育后续孩子的可能性较小，并且生育的孩子也少于阴道分娩第一个孩子的妇女。然而，几乎所有这些研究都是回顾性分析现有数据集，或对女性首次分娩数年后的调查。因此，尚不清楚女性是否通过剖腹产分娩第一个孩子的女性与在分娩前阴道分娩的女性不同首次分娩的方式既使她们倾向于需要剖腹产分娩，又不太可能想要或能够怀孕并生育一个或多个后续孩子，或者如果有任何关于剖腹产本身会影响女性怀孕或生育后续孩子的愿望或能力。给定最近美国和世界各国的剖腹产率有所上升精心设计、精心进行、前瞻性、纵向研究和充分的统计数据至关重要加强对剖宫产增加程度的科学认识女性随后不孕的风险，如果是，原因是什么。这项关于生育的前瞻性纵向研究与首次分娩方式相关的模式是对增加女性分娩风险的两个因素的调查通过剖腹产产下她的第一个孩子，以及初次剖腹产对重要的影响结果，包括随后的生育。本研究的具体目标是： 1.) 衡量预先通过对 2790 名孕妇的不同样本进行分娩的愿望和意图旨在评估可解释剖腹产后缺陷的产前因素的访谈生育，2.) 衡量这 2790 名医院病历中与分娩相关的因素可以解释剖腹产后生育缺陷的女性，以及 3.) 确定影响通过一项为期 3 年的前瞻性纵向研究，初步剖宫产对随后生育的影响对 2790 名女性进行了首次分娩后 1、6、12、18、24、30 和 36 个月的评估，比较了考虑到产前测量的因素，对阴道分娩的人进行剖腹产分娩分娩面谈和医院病历。项目叙述过去十年，美国的剖腹产率急剧上升，超过一百万妇女每年都会通过剖腹产分娩。这项研究将调查剖腹产的程度增加女性随后不孕的风险，并将大大提高目前的科学水平关于这个问题的知识。