与延长劳动的潜伏阶段相关的风险
Julia Burd1, Candice Woolfolk1, Michael Dombrowski1
1Division of Maternal Fetal Medicine, Washington University at St. Louis, St. Louis, Missouri.
American journal of perinatology
|September 24, 2024
概括
在分娩中延长的潜伏阶段 (PLP) 增加了自发和诱导分娩的孕产妇发病风险. 在自发分娩中,PLP也会增加新生儿发病风险,这与剖腹产分娩率无关.
科学领域:
- 产科和妇科 产科和妇科
- 孕产妇和胎儿医学 孕产妇和胎儿医学
- 产周研究 产周研究
背景情况:
- 劳动的潜伏阶段是分娩的关键时期.
- 了解影响分娩进展和结果的因素对于优化产妇和新生儿护理至关重要.
- 长时间的分娩阶段可能与不良结果有关,需要进一步调查.
研究的目的:
- 评估延长潜伏期 (PLP) 与孕产妇和新生儿发病率之间的关联.
- 为了比较患有PLP和没有PLP的患者的结局,按分娩诱导状态和分娩方式分层.
主要方法:
- 一项前性队列研究 (2010-2015年) 的二次分析,其中包括6509名末期孕妇.
- PLP定义为劳动持续时间≥90百分点从入院到活动劳动 (6厘米).
- 使用多变量逻辑回归评估的复合孕产妇和新生儿发病结果,经过调整以考虑混因素.
主要成果:
- 患有PLP的患者在诱导 (aOR: 1.36) 和自发分娩 (aOR: 1.49) 两种情况下都显著增加了母体综合发病率.
- 新生儿发病率在PLP的自发分娩中显著增加 (aOR: 1.57).
- 在PLP组中,剖腹产率较高 (25.1%对14.0%),但PLP与孕产妇发病率的关联甚至在调整分娩方式后仍然存在.
结论:
- 长时间的潜伏阶段在第90百分位或以上与增加的孕产妇发病率有关,不管是产业诱导还是剖腹产.
- 在自发分娩中,PLP也与新生儿发病率的风险更高有关.
- 需要进一步的研究,以确定临床管理指南的最佳潜伏期切线.
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