剖宫产分娩对婴儿健康影响的前瞻性研究  

Effects of Cesarean Section on Infant Health: Matched Prospective Cohort Study

作　　者：梁红[1] 周利锋[1] 王炳顺[2] 钟烨[3] 朱丽萍 高尔生[1] 

机构地区：[1]上海市计划生育科学研究所,上海200032 [2]交通大学医学院,上海200025 [3]美国宾夕法尼亚大学 [4]上海市妇幼保健所,上海200040

出　　处：《生殖与避孕》2007年第2期124-127,132,共5页Reproduction and Contraception

基　　金：国家自然科学基金资助项目(30070667)

摘　　要：目的:了解剖宫产分娩对婴儿健康的影响。方法:采用配对前瞻性队列研究,选取602名不具备剖宫产术绝对指征的妇女及其新生儿为对象,其中301名妇女为剖宫产分娩,301名妇女为阴道分娩,二组对象按照手术指征进行配对,分别在产后1个月、6个月及12个月进行随访,了解婴儿的健康状况。结果:产后近期及各次随访期间未发现剖宫产、阴道分娩二组婴儿疾病发生危险的差异。产后1个月剖宫产儿因病住院率相对低于阴道分娩儿,但1年总计,二组婴儿因病住院比例的差别无统计学意义。婴儿常见病1年总计比较的结果发现剖宫产后发生婴儿腹泻的危险是阴道分娩儿的1.25倍(95%CI:1.01-1.56)。结论:不具备剖宫产术绝对指征的妇女,剖宫产与婴儿疾病的发生没有关联,但有增加婴儿腹泻发生的危险。Objective： To understand the effects of cesarean section on infant health. Methods： A total of 301 healthy women with cesarean section and a matched control group of 301 women delivered vaginally were identified by matched prospective cohort study at three district-level hospitals in Shanghai from May 2001 to February 2003. Two groups were matched according to their medical indications for cesarean section. Their infants were assessed at delivery, month 1, month 6 and year 1 after birth. Results： The incidence of neonatal complications and infant morbidities at all measurement occasions did not differ significantly between two groups. Rehospitalization was found to be less likely among infants delivered by cesarean section in the first month after birth. However, there was no difference between two groups in rehospitalization rates in the first year after birth. Cesarean section was also associated with a higher risk of infant diarrhea （adjusted relative risk=1.25, 95% CI： 1.01, 1.56）. Conclusion： Infants do not have health benefits from cesarean section if the pregnancy is at low risk.

关 键 词：剖宫产 婴儿 疾病 发生率 

分 类 号：R719.8[医药卫生—妇产科学]