Early human development · 2014
The impact of cesarean section on neonatal outcome of infants born at 23weeks of gestation.
СтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Furukawa Seishi, Sameshima Hiroshi, Ikenoue Tsuyomu
Аннотация
OBJECTIVE: Determine the impact of cesarean section (CS) on neonatal outcome of infants born at 23weeks of gestation.
METHODS: A retrospective study was performed involving 34 infants born at 23weeks and 91 infants born at 24-26weeks. Indications necessitating delivery were severe pregnancy induced hypertension, non-reassuring fetal heart rate patterns (NRFHRs), or intrauterine infection (IUI). Obstetrical indication for CS included NRFHR and breech presentation. Poor outcome included neonatal death or cerebral palsy. Univariate and multiple logistic analyses were performed to determine the effect of CS for obstetrical indications on poor outcome.
RESULTS: The incidence of poor outcome was significantly higher at 23weeks (number of poor outcomes/total number: 22/34) compared to that (31/91) at 24-26weeks (p<0.01). The incidence of a poor outcome was significantly higher at 23weeks for infants having NRFHR (11/16) compared to those at 24-26weeks (15/43, p=0.02). However, the incidence of a poor outcome was similar in infants with IUI (6/10 at 23weeks versus 5/11 at 24-26weeks, p=0.41). Vaginal birth in cases of obstetrical indication for CS at 23weeks was associated with higher risk of a poor outcome (odds ratio: 8.2). In contrast, the risk at 24-26weeks was not higher (OR, 0.8). After adjustment using variables of vaginal birth and IUI, vaginal birth significantly affected poor outcome (OR, 13.0).
CONCLUSION: Poor neonatal outcome was closely related to the mode of delivery, suggesting that CS for obstetrical indication at 23weeks may improve neonatal outcome.
METHODS: A retrospective study was performed involving 34 infants born at 23weeks and 91 infants born at 24-26weeks. Indications necessitating delivery were severe pregnancy induced hypertension, non-reassuring fetal heart rate patterns (NRFHRs), or intrauterine infection (IUI). Obstetrical indication for CS included NRFHR and breech presentation. Poor outcome included neonatal death or cerebral palsy. Univariate and multiple logistic analyses were performed to determine the effect of CS for obstetrical indications on poor outcome.
RESULTS: The incidence of poor outcome was significantly higher at 23weeks (number of poor outcomes/total number: 22/34) compared to that (31/91) at 24-26weeks (p<0.01). The incidence of a poor outcome was significantly higher at 23weeks for infants having NRFHR (11/16) compared to those at 24-26weeks (15/43, p=0.02). However, the incidence of a poor outcome was similar in infants with IUI (6/10 at 23weeks versus 5/11 at 24-26weeks, p=0.41). Vaginal birth in cases of obstetrical indication for CS at 23weeks was associated with higher risk of a poor outcome (odds ratio: 8.2). In contrast, the risk at 24-26weeks was not higher (OR, 0.8). After adjustment using variables of vaginal birth and IUI, vaginal birth significantly affected poor outcome (OR, 13.0).
CONCLUSION: Poor neonatal outcome was closely related to the mode of delivery, suggesting that CS for obstetrical indication at 23weeks may improve neonatal outcome.