与非糖尿病妇女相比,孕期糖尿病和活跃劳动的持续时间:基于人口的队列研究
Sofia Nevander1, Sara Carlhäll1, Karin Källén2
1Department of Obstetrics and Gynecology and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.
概括
孕期糖尿病的妇女经历了更长的活跃分娩持续时间和更高的剖腹产率. 这强调了糖尿病患者在分娩期间需要医疗保健提供者的更多支持和耐心.
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
- 内分泌学 在内分泌学.
背景情况:
- 孕期糖尿病 (PGDM) 是妊娠不良结果的重要危险因素.
- 了解其对分娩进展和分娩方式的影响对于优化产妇护理至关重要.
研究的目的:
- 评估PGDM对诱导和自发分娩的活跃分娩 (DAL) 持续时间的影响.
- 为了比较PGDM和没有PGDM的女性之间的剖腹产 (CS) 率和指示.
主要方法:
- 在瑞典进行了一项基于人口的队列研究.
- 分析了243537名女性 (2014-2020年) 的数据,不包括妊娠糖尿病患者.
- 使用Kaplan-Meier生存和Cox回归分析来比较DAL和CS结果.
主要成果:
- 与非糖尿病女性相比,患有PGDM的女性的DAL显著更长 (调整后危险比率为0.65).
- 糖尿病女性的中位数DAL分别为9.60小时与8.75小时的自发分娩和8.92小时与7.20小时的诱导分娩.
- 在PGDM的妇女中观察到较高的选择性 (7.4%对2.6%) 和紧急 (29.4%对7.1%) CS,怀疑巨和胎儿痛苦作为主要迹象.
结论:
- 患有PGDM的妇女的延长分娩时间需要分娩病房工作人员的加强支持和耐心.
- 在诊断dystocia之前,考虑扩展分娩管理可能是有益的.
- 这些发现也可能为改善糖尿病妇女分娩经验的策略提供信息.
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