初次剖宫产对再次妊娠结局的影响

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摘要目的探讨初次剖宫产对孕妇再次妊娠结局的影响。方法本文采用前瞻性队列研究方法,收集2014年8月－2015年8月在北京市顺义区妇幼保健院产科建册并分娩第二胎的单胎孕妇1 357例,其中失访39例,排除孕周>20周的48例,合并内外科疾病的52例,最终纳入本研究1 218例。按初次妊娠分娩方式分为剖宫产组(n=550)和阴道分娩组(n=668),比较两组母婴结局。结果剖宫产组孕妇产后出血(32.4%)和胎盘植入综合征(2.4%)的发病率高于阴道分娩组(8.1%和0.6%),两组比较差异有统计学意义,剖宫产组围生儿呼吸窘迫综合征发病风险有升高趋势(RR=2.02,95% CI:0.48～8.55)。结论剖宫产对孕妇再次妊娠造成不良影响,应严格遵循剖宫产指征,尽可能地减少非医学指征的剖宫产的发生几率。

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	麻伟博
	孙彦华

关键词 ：剖宫产分娩, 再次妊娠, 产后出血, 胎盘植入综合征, 呼吸窘迫综合征

Abstract：Objective The purpose of this study was to explore the impact of primary cesarean delivery on the outcomes of subsequent pregnancy. Methods This prospective survey was conducted on 1218 singleton second pregnant women who registered and delivered from August 2014 to August 2015. Data were retrieved and analyzed from Maternal and Child Health Care Hospital of Shunyi District. Women were divided into two groups: cesarean delivery and vaginal delivery according to the mode of first delivery.Results Compared with the vaginal group, the incidence of postpartum hemorrhage and placenta accrete in the cesarean group was higher (P<0.05). Cesarean delivery increased the risk of respiratory distress syndrome of newborn (RR=2.02, 95% CI: 0.48-8.55).Conclusion Adverse effect associated with primary cesarean section was observed on subsequent pregnancy. It is recommended that indications for cesarean section need to be strictly followed in order to lower the rate of cesarean delivery without medical indications.

Key words： Cesarean delivery Postpartum hemorrhage Placenta accrete Respiratory distress syndrome

通讯作者: 麻伟博(maweibodoc@126.com)

引用本文:

麻伟博, 孙彦华. 初次剖宫产对再次妊娠结局的影响[J]. 中国生育健康杂志, 2016, 27(4): 321-323.
MA Weibo, SUN Yanhua. Impact of primary cesarean delivery on the outcomes of subsequent pregnancy. Chinese Journal of Reproductive Health, 2016, 27(4): 321-323.

链接本文:

http://cjrh.bjmu.edu.cn/CN/ 或 http://cjrh.bjmu.edu.cn/CN/Y2016/V27/I4/321

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