| Autor: |
Hedegaard, M, Lidegaard, Ø, Skovlund, CW, Mørch, LS |
| Předmět: |
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| Zdroj: |
BJOG: An International Journal of Obstetrics & Gynaecology; Sep2015, Vol. 122 Issue 10, p1377-1385, 9p, 3 Charts, 2 Graphs |
| Abstrakt: |
Objective To assess the changes in perinatal outcomes in children born from 37 weeks of gestation after implementation of a more proactive labour induction practice from 2009. Design Register-based cohort study. Setting Denmark, 2000-12. Population Newborns from 37 weeks of gestation. Methods Perinatal outcomes were estimated using a logistic regression analysis with adjustment for gestational age, maternal age, parity, plurality, smoking and body mass index. Main outcome measures Perinatal outcomes. Results A total of 770 926 infants were included. Labour induction from 37 weeks increased from 9.7% in 2000-02 to 22.5% in 2011-12. From 2003-05 to 2011-12, the risk of umbilical cord pH < 7.0 decreased by 23%; odds ratio ( OR) 0.77 (95% confidence interval 0.67-0.89), and the adjusted OR of Apgar score < 7 at 5 minutes was unchanged. The risk of admission to neonatal intensive care units increased by 56%; OR 1.56 (1.47-1.66), whereas the risk of neonatal deaths decreased by 44%; OR 0.56 (0.45-0.70). The risk of cerebral palsy was from 2000-02 to 2009-10 reduced by 26%; OR 0.74 (0.60-0.90). The proportion of infants born with fetal weight ≥ 4500 g decreased by one-third; OR 0.68 (0.65-0.71). However, the risk of shoulder dystocia increased by 32%; OR 1.32 (1.21-1.44), whereas the risk of peripheral nerve injuries was reduced by 43%; OR 0.57 (0.45-0.73). Conclusion The results suggest an overall improvement in perinatal outcomes as a result of a more proactive post-term labour induction practice. [ABSTRACT FROM AUTHOR] |
| Databáze: |
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