第一个和第二个分娩阶段的持续时间以及产前期的结果
Mia Elida Larsen Ersdal1, Ketil Størdal2, Yuda Munyaw3
1Faculty of Medicine, Oslo University, Norway.
Early human development
|July 17, 2025
概括
第一个阶段的分娩时间与不良的周产期结果没有相关性. 然而,持续一个小时或更长时间的第二阶段分娩显著增加了新生儿不良结果的风险.
科学领域:
- 产科和妇科 产科和妇科
- 围产期健康 围产期健康
- 孕产妇和胎儿医学 孕产妇和胎儿医学
背景情况:
- 世界卫生组织 (WHO) 在2018年更新了劳动指南,为劳动持续时间引入了新的警报值.
- 在各种环境中评估这些新建议对于优化产科护理至关重要.
- 了解分娩时间和产周期结果之间的关系对于临床决策至关重要.
研究的目的:
- 评估分娩第一阶段和第二阶段的持续时间与周围产生的不良结果之间的关联.
- 评估2018年世卫组织关于在坦桑尼亚农村医院分娩时间的警报值的适用性.
- 调查分娩时间对产内死胎和24小时新生儿结果的影响.
主要方法:
- 从2013年3月到2018年11月,在坦桑尼亚农村的海多姆路德医院进行了一项前性观察研究.
- 分析了12481例分娩的数据,不包括剖腹产,多胎和产前死产.
- 使用后勤回归模型来确定分娩时间和24小时围产期结果之间的关联.
主要成果:
- 在分娩第一阶段的持续时间和不良周产期结果 (p=0.431) 之间没有发现显著的关联.
- 持续一个小时或更长时间的第二阶段分娩与不良周产期结果有显著的关联 (OR 3.38,95% CI 1.95-5.88).
- 在对胎儿心率,妊娠年龄和出生体重进行调整后,这种关联仍然显著.
结论:
- 第一个分娩阶段的持续时间不是对周产期不良结果的可靠预测指标.
- 长时间的第二阶段分娩 (≥1小时) 是产周期不良结果的重要风险因素.
- 这些发现挑战了当前的世卫组织2018年关于劳动管理和警报值的建议.
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