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产科关损伤的预测因素和不明原因的变化:基于人口的横截面分析

Christopher X Hong¹, Pamela S Fairchild², Payton C Schmidt²

¹Department of Obstetrics and Gynecology, University of Michigan, University Hospital South, 1500 E. Medical Center Dr., L4011, Ann Arbor, MI, 48109, USA. cxhong@med.umich.edu.

International urogynecology journal

|November 1, 2024

概括

产科关节损伤 (OASI) 在1.1%的阴道分娩中发生. 阴道平价和手术分娩是最强的临床预测因素,但大多数OASI病例仍然无法由这些因素解释.

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
流行病学流行病学

背景情况:

产科关节损伤 (OASIs) 是分娩中的一个重大问题.
了解OASIs的发病率和风险因素对于改善母亲的结果至关重要.
现有的文献表明,几个临床因素可能会影响OASI风险.

研究的目的:

为了确定美国人口中OASI的发病率.
评估OASIs个人和集体临床风险因素的预测能力.
使用大型出生登记册识别OASIs的关键预测因素.

主要方法:

一项利用美国国家生命统计系统数据 (2016-2021) 的横截面研究.
包括所有阴道分娩,但不包括未指定的分娩途径或周围裂状态的分娩.
后勤回归模型和伪R平方 (pR2) 值,以评估临床风险因素的预测力.

主要成果:

分析了15413957例阴道分娩;整体OASI发生率为1.1%.
阴道平价 (pR2 5.8%) 和手术分娩 (pR2 4.8%) 是OASIs最具预测性的因素.
婴儿体重显示中等预测能力 (pR2 1.5%),而其他因素的预测能力很小 (pR2 ≤ 0.5%).
多变量模型解释了11.8%的OASI变化.

结论:

阴道平价和手术分娩是OASIs的显著临床预测因素,每一个对结果变化贡献约5%.
很大一部分OASIs并不能通过当前的临床风险因素来解释.
需要对OASI机制进行进一步的研究,以开发有针对性的干预措施并识别高风险个体.

关键词:

国家重要统计数据.在OASIs的基础上,OASIs是OASIs.产科关节损伤产科关节损伤操作性分娩是如何进行的周围的破伤.基于人口的发病率.

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