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首页> 外文期刊>American Journal of Obstetrics and Gynecology >Maternal and neonatal outcomes in electively induced low-risk term pregnancies
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Maternal and neonatal outcomes in electively induced low-risk term pregnancies

机译：择期诱发的低危足月妊娠的母亲和新生儿结局

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Objective Elective induction of labor has been discouraged over concerns regarding increased complications. We evaluated the mode of delivery and maternal and neonatal morbidities in low-risk patients whose labor was electively induced or expectantly managed at term. Study Design This was a retrospective cross-sectional study from 12 US institutions (19 hospitals), 2002 through 2008 (Safe Labor Consortium). Healthy women with viable, vertex singleton pregnancies at 37-41 weeks of gestation were included. Women electively induced in each week were compared with women managed expectantly. The primary outcome was mode of delivery. Results Of 131,243 low-risk deliveries, 13,242 (10.1%) were electively induced. The risk of cesarean delivery was lower at each week of gestation with elective induction vs expectant management regardless of parity and modified Bishop score (for unfavorable nulliparous patients at: 37 weeks = 18.6% vs 34.2%, adjusted odds ratio, 0.40; [95% confidence interval, 0.18-0.88]; 38 weeks = 28.4% vs 35.4%, 0.65 [0.49-0.85]; 39 weeks = 23.6% vs 38.5%, 0.47 [0.38-0.57]; 40 weeks = 32.3% vs 42.3%, 0.70 [0.59-0.81]). Maternal infections were significantly lower with elective inductions. Major, minor, and respiratory neonatal morbidity composites were lower with elective inductions at ≥38 weeks (for nulliparous patients at: 38 weeks = adjusted odds ratio, 0.43; [95% confidence interval, 0.26-0.72]; 39 weeks = 0.75 [0.61-0.92]; 40 weeks = 0.65 [0.54-0.80]). Conclusion Elective induction of labor at term is associated with decreased risks of cesarean delivery and other maternal and neonatal morbidities compared with expectant management regardless of parity or cervical status on admission.
机译：客观原因由于对并发症增加的担忧，不鼓励选择性地引产。我们评估了足月择期引产或预期管理分娩的低危患者的分娩方式以及母婴患病率。研究设计这是一项回顾性横断面研究，来自2002年至2008年（美国安全劳工协会）的12家美国机构（19家医院）。纳入了在妊娠37-41周时可行，单胎妊娠的健康女性。将每周选出的女性与预期管理的女性进行比较。主要结果是分娩方式。结果131,243例低风险分娩中，选择性地诱发了13,242例（10.1％）。不论是否接受胎次和Bishop评分的改善，择期诱导妊娠每周剖宫产的风险均低于预期管理（不良原产妇：37周= 18.6％vs 34.2％，校正比值比为0.40; [95％置信区间0.18-0.88]; 38周= 28.4％vs 35.4％，0.65 [0.49-0.85]; 39周= 23.6％vs 38.5％，0.47 [0.38-0.57]; 40周= 32.3％vs 42.3％，0.70 [0.59-0.81]。选择性诱导可使孕产妇感染率明显降低。 ≥38周时，择期诱导的主要，次要和呼吸道新生儿发病率综合指数更低（对于以下情况下的未产患者：38周=调整后的优势比为0.43; [95％置信区间为0.26-0.72]; 39周= 0.75 [0.61] -0.92]; 40周= 0.65 [0.54-0.80]。结论与预期管理相比，足月择期引产与降低剖宫产和其他母婴新生儿发病率的风险有关，而不论是否接受同等或宫颈检查。

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