选择性剖宫产对(近)足月儿发生呼吸窘迫综合征的影响

目的 探讨选择性剖宫产对(近)足月儿呼吸窘迫综合征(RDS)发生的影响.方法 以2008年11月-2009年10月在郑州大学第三附属医院NICU住院的76例诊断为RDS的(近)足月儿为研究对象,分析其分娩方式、胎龄分布.RDS(近)足月儿根据分娩方式分为2组:选择性剖宫产组和阴道分娩组,比较不同分娩方式RDS发生风险的高低;足月儿选择性剖宫产组根据胎龄分为2组,37~38+6周组和39~41+6周组,比较不同胎龄选择性剖宫产RDS发生风险的高低.结果 76例RDS(近)足月儿中63例为选择性剖宫产,占82.9%.(近)足月儿选择性剖宫产组RDS发生风险显著高于阴道分娩组(OR=2.38,95%CI 1.06~5.33,P<0.05),随着胎龄增加,RDS发病例数逐渐降低,但差异无统计学意义(P>0.05).足月儿选择性剖宫产组RDS发生风险显著高于阴道分娩组(OR=4.14,95%CI 1.58~10.90,P<0.01),这种风险在37~38+6周组显著升高(OR=4.50,95%CI 1.10~18.20,P<0.05),39周之后不再升高,且与阴道分娩组相比差异无统计学意义(P>0.05).结论 选择性剖宫产是(近)足月儿发生RDS的重要危险因素,且选择性剖宫产时机对(近)足月儿发生RDS也很重要.如果条件允许,足月儿选择性剖宫产分娩应在39周以后进行,可显著减少RDS发生.

Influence of Elective Caesarean Section on Respiratory Distress Syndrome in Near-Term and Term Neonates

Objective To explore the influence of elective caesarean section on respiratory distress syndrome(RDS)in near-term and term neonates.Methods A retrospective study was conducted at the neonatal intensive care unit(NICU)of the Third Affiliated Hospital of Zhengzhou University in 76 near-term and term neonates who were diagnosed as RDS from Nov.2008 to Oct.2009.The mode of delivery and gestational age distribution were studied.Near-term and term neonates who developed RDS were divided into 2 groups according t...