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在母亲的要求下进行剖腹产后的婴儿感染:基于人口的队列研究
Yanfang Guo1, Malia S Q Murphy2, Sheryll Dimanlig-Cruz1
1Better Outcomes Registry and Network (BORN), Ottawa, ON; Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON.
概括
按母亲要求进行剖腹产 (CDMR) 与计划的阴道分娩相比,不会增加婴儿感染风险. 然而,实际的剖腹产与更高的婴儿感染率有关.
科学领域:
- 产科和妇科 产科和妇科
- 新生儿健康 新生儿健康
- 流行病学 流行病学
背景情况:
- 在母亲要求的剖腹产 (CDMR) 调查中,经常使用含有不清楚指示的行政数据.
- 了解CDMR与婴儿感染风险之间的关联对于临床实践至关重要.
研究的目的:
- 使用治疗意图方法确定CDMR和婴儿感染风险之间的关联.
- 为了比较计划的CDMR和计划的阴道分娩 (VDs) 之间的感染风险.
主要方法:
- 在加拿大安大略省 (2012-2018) 的低风险单子妊娠的基于人口的队列研究.
- 排除之前的CD,分析呼吸道,胃肠道和耳部感染长达1年.
- 治疗意图分析与随后的治疗敏感性分析.
主要成果:
- 计划中的CDMR (0.4%的出生) 没有显示出复合婴儿感染的风险增加 (aRR1.02;95% CI 0.92-1.11).
- 亚组和灵敏度分析的结果相似.
- 实际的CD (计划和非计划) 与实际的VD相比,与婴儿感染风险的增加有关.
结论:
- 计划的CDMR与计划的风险相比,与新生儿或婴儿感染风险的增加无关.
- 研究设计,特别是治疗意图与被治疗的结果,对CDMR和婴儿感染的发现产生重大影响.
- 在评估CDMR对婴儿结果的影响时,仔细考虑研究设计是必不可少的.
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