产后出血的风险随着第一阶段分娩持续时间的增加而增加
Linnea V Ladfors1, Xingrong Liu2, Anna Sandström2,3
1Clinical Epidemiology Division, Department of Medicine, Karolinska Institutet, Solna, Stockholm, Sweden. linnea.ladfors@ki.se.
Scientific reports
|September 27, 2024
概括
长时间的分娩时间,特别是第一阶段,显著增加了第一次母亲的产后出血 (PPH) 风险. 较长时间的分娩也会增加延长第二阶段和剖腹产的风险,导致PPH.
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
- 生殖健康 生殖健康
背景情况:
- 在高收入国家,产后出血 (PPH) 率正在上升.
- 劳动时间对PPH风险的影响需要进一步调查.
研究的目的:
- 检查活跃第一阶段劳动持续时间和PPH风险之间的关联.
- 探索第二阶段劳动持续时间和剖腹产 (CD) 在这种关系中的调解作用.
主要方法:
- 这项研究包括了77,690名无产妇,自发分娩的妇女.
- 由宫扩张和出生时间定义的分娩阶段.
- 用于评估风险和关联的修改Poisson回归和调解分析.
主要成果:
- 超过12.1小时的第一个分娩阶段与与7.7小时以下的分娩相比,PPH风险增加了1.5倍.
- 延长的第一阶段分娩占PPH风险增加的18.5%,由延长的第二阶段分娩或CD介导.
- 剖腹产和延长的第二阶段劳动被确定为重要的调解者.
结论:
- 活跃的第一阶段分娩持续时间是确定无产妇妇女PPH风险的关键因素.
- 将第一阶段的分娩时间纳入产后评估可以提高PPH风险预测.
- 这一发现特别适用于初次母亲,她们的分娩自发发,为期,单子,顶部呈现的胎儿.
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