Effect of Maternal Risk Characteristics on Neonatal Outcome Correlated to Mode of Delivery

出生方式對新生兒預後及母親罹病率之影響

陳淑貞(Shu-Jen Chen) ； 藍忠孚(Chung-Fu Lan) ； 余玉眉(Yuh-Mei Yu Chao) ； 陸振翮(Jen-Her Lu)

《中華公共衛生雜誌》 16卷1期 (1997/02) Pp. 52-61

https://doi.org/10.6288/CJPH1997-16-01-05

摘要

This paper explores the associations among modes of delivery, maternal and perinatal outcome and risk factors of pregnancy. We examined medical birth register data of 18539 infants from 18249 deliveries admitted to ten delivery units from Feb. 1992 to Feb. 1993. After controlling the potential confounding effect of maternal and infant characteristics, the outcome measures of different modes of delivery were compared. Incidence of high risk pregnancy was 33.2% (n=6051); in this group, in comparison with vaginal delivery, cesarean section was associated with higher maternal morbidity (11.2% vs 3.4%; p＜0.00l.), but lower neonatal morbidity and perinatal mortality (9.4% vs 28%, 0.8% vs 6.2% respectively; p＜0.00l). Moreover, multiple logistic regression analysis showed vaginal delivery increased the perinatal mortality (odds ratio: 4.0.95% confidence interval: 2.5-6.2, p＜0.01) and neonatal morbidity (odds ratio: 1.8.95% confidence interval: 1.4-2.4, p＜0.001) but decreased the materal morbidity (odds ratio: 0.24, 95% confidence interval: 0.18-0.32. p＜0.00l). In non-high risk preganancy (n=12198), cesarean section was also associated with higer maternal morbidity (3.7% vs 1.2%; p＜0.001), but for neonatal morbidity and perinatal mortality there was no difference with different modes of delivery In conclusion, cesarean section was associated with a better birth neonatal outcome in high risk pregnancy; however, it raised maternal morbidity without improving the neonatal outcome in non-high risk pregnancy.

關鍵字

高危險妊娠 ； 剖腹生產 ； 母親罹病率 ； 新生兒預後

並列摘要

This paper explores the associations among modes of delivery, maternal and perinatal outcome and risk factors of pregnancy. We examined medical birth register data of 18539 infants from 18249 deliveries admitted to ten delivery units from Feb. 1992 to Feb. 1993. After controlling the potential confounding effect of maternal and infant characteristics, the outcome measures of different modes of delivery were compared. Incidence of high risk pregnancy was 33.2% (n=6051); in this group, in comparison with vaginal delivery, cesarean section was associated with higher maternal morbidity (11.2% vs 3.4%; p＜0.00l.), but lower neonatal morbidity and perinatal mortality (9.4% vs 28%, 0.8% vs 6.2% respectively; p＜0.00l). Moreover, multiple logistic regression analysis showed vaginal delivery increased the perinatal mortality (odds ratio: 4.0.95% confidence interval: 2.5-6.2, p＜0.01) and neonatal morbidity (odds ratio: 1.8.95% confidence interval: 1.4-2.4, p＜0.001) but decreased the materal morbidity (odds ratio: 0.24, 95% confidence interval: 0.18-0.32. p＜0.00l). In non-high risk preganancy (n=12198), cesarean section was also associated with higer maternal morbidity (3.7% vs 1.2%; p＜0.001), but for neonatal morbidity and perinatal mortality there was no difference with different modes of delivery In conclusion, cesarean section was associated with a better birth neonatal outcome in high risk pregnancy; however, it raised maternal morbidity without improving the neonatal outcome in non-high risk pregnancy.

並列關鍵字

High risk pregnancy ； Cesarean section ； Maternal morbidity ； Neonatal outcome