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分娩方式和随后的出生率:芬兰全国范围的基于登记册的分析
Matias Vaajala1, Rasmus Liukkonen1, Ville M Mattila1,2
1Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland.
概括
随后的出生率因分娩方式而异. 辅助性阴道分娩和非计划性剖腹产 (CS) 与较高的后续出生率有关,而选择性CS与自发性阴道分娩相比的较低率有关.
科学领域:
- 生殖健康 生殖健康
- 产科 产科 产科 产科 产科
- 流行病学 流行病学
背景情况:
- 了解不同分娩方式后的后续出生率对于生殖健康规划至关重要.
- 以前的研究表明,分娩方式和未来的生育率之间存在关联,但需要全面的全国数据.
研究的目的:
- 在各种分娩方式中计算和比较随后的出生率,包括自发性阴道分娩,辅助性阴道分娩和剖腹产 (CS).
- 根据第一次分娩的模式,确定影响第二次怀孕风险的因素.
主要方法:
- 利用国家医疗出生登记 (MBR) 的数据,用于2004年至2018年间第一次和第二次分娩的妇女.
- 采用考克斯回归模型来分析第二次怀孕的风险,根据第一次分娩的分娩方式进行调整.
- 用95%的置信区间 (CI) 计算调整的危险比率 (aHR),以解释结果.
主要成果:
- 包括375,619名女性,分为自发性阴道分娩,辅助性阴道分娩,非计划性阴道分娩和选择性阴道分娩的不同组.
- 经过辅助性阴道分娩 (aHR,1.23) 和非计划性阴道分娩 (aHR,1.03) 的女性的后期分娩率较高.
- 与自发性阴道分娩相比,有选择性CS的妇女 (aHR,0.86) 的后期分娩率较低.
结论:
- 剖腹产本身可能不仅仅解释了随后较低的出生率.
- 除了手术之外的潜在因素似乎对生育率和随后的出生率有很大的影响.
- 这些发现凸显了不同分娩经历后生殖结果的复杂性.
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