剖腹产和在随后的怀孕中无法解释的死产的风险
Gordon C S Smith1, Jill P Pell, Richard Dobbie
1Department of Obstetrics and Gynaecology, Cambridge University, Cambridge, UK. gcss2@cam.ac.uk
Lancet (London, England)
|December 5, 2003
概括
经过剖腹产分娩的妇女在随后的怀孕中可能面临无法解释的死产的风险增加. 这种风险特别高于怀孕34周,与阴道分娩相比,风险翻倍.
科学领域:
- 产科和妇科 产科和妇科
- 围产期流行病学 围产期流行病学
- 孕产妇和胎儿医学 孕产妇和胎儿医学
背景情况:
- 剖腹产与未来怀孕中的胎盘疾病有关.
- 剖腹产前分娩对产前死产风险的影响尚不清楚.
研究的目的:
- 确定之前的剖腹产是否会增加后期怀孕中产前死产的风险.
主要方法:
- 链接苏格兰出院数据 (1980-1998) 和死胎/婴儿死亡记录 (1985-1998).
- 使用时间到事件分析来估计第二次怀孕中产前死产的相对风险.
主要成果:
- 总共有120,633个单独的第二次出生被分析.
- 与阴道分娩 (1.44/10,000每周;p<0.001) 相比,先前剖腹产的妇女的产前死产率 (2.39/10,000每周) 高于阴道分娩的妇女 (1.44/10,000每周;p<0.001).
- 不能解释的死胎的过度风险从怀孕34周开始就显而易见,并且在调整母亲因素后仍然存在.
结论:
- 第一次怀孕的剖腹产可能会增加第二次怀孕中无法解释的死产的风险.
- 对于之前做过一次剖腹产的女性来说,39周或之后无法解释的产前死产的风险大约是死产或由子宫破裂引起的新生儿死亡的两倍.
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