Xiaohua Liu1, Mark B Landon2, Weiwei Cheng3, Yan Chen3. 1. Department of Obstetrics, International Peace Maternity and Child Health Hospital, Shanghai Jiaotong University. Shanghai, China. Electronic address: Annaabcd114@hotmail.com. 2. Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, The Ohio State University College of Medicine, Columbus, OH. 3. Department of Obstetrics, International Peace Maternity and Child Health Hospital, Shanghai Jiaotong University. Shanghai, China.
Abstract
OBJECTIVE: The purpose of this study was to describe the risks and benefits of cesarean delivery on maternal request (CDMR) in a Chinese population. STUDY DESIGN: A retrospective cohort study of mode of delivery was conducted at the largest obstetric center in Shanghai, China, from 2007-2013. Eligibility criteria included singleton term nulliparous women with vertex presentation; women with major fetal anomalies or stillbirth before labor were excluded. RESULTS: A total of 66,226 women were included in the analysis: 40,560 women (61.2%) had planned vaginal birth, with 32,833 spontaneous vaginal deliveries (80.9%), 4990 intrapartum CDs (12.3%), and 2737 assisted vaginal deliveries (6.7%). A total of 16,333 women (24.7%) underwent CDMR. We observed no significant difference between the CDMR and planned vaginal delivery groups in the frequencies of maternal intensive care unit admission (0.2% vs 0.2%), severe postpartum hemorrhage (0.5% vs 0.5%), maternal infection (1.3% vs 1.3%), organ injuries (0.4‰ vs 0.5‰), and thromboembolic disorders (0.1‰ vs 0.1‰). The perinatal mortality rate was similar in the 2 groups (0.4‰ vs 0.6‰; adjusted odds ratio, 0.51; 95% confidence interval, 0.20-1.30; P = .159). The frequencies of birth trauma (0.2‰ vs 1.1‰), neonatal infection (0.4% vs 0.7%), hypoxic ischemic encephalopathy (0.4‰ vs 1.8‰), and meconium aspiration syndrome (0.2‰ vs 0.6‰) were lower; the frequency of respiratory-distress syndrome (0.6% vs 0.4%) was higher in the CDMR group. CONCLUSION: Compared with nulliparous women who tried vaginal delivery, women who underwent CDMR had similar short-term maternal outcomes with some neonatal benefit.
OBJECTIVE: The purpose of this study was to describe the risks and benefits of cesarean delivery on maternal request (CDMR) in a Chinese population. STUDY DESIGN: A retrospective cohort study of mode of delivery was conducted at the largest obstetric center in Shanghai, China, from 2007-2013. Eligibility criteria included singleton term nulliparous women with vertex presentation; women with major fetal anomalies or stillbirth before labor were excluded. RESULTS: A total of 66,226 women were included in the analysis: 40,560 women (61.2%) had planned vaginal birth, with 32,833 spontaneous vaginal deliveries (80.9%), 4990 intrapartum CDs (12.3%), and 2737 assisted vaginal deliveries (6.7%). A total of 16,333 women (24.7%) underwent CDMR. We observed no significant difference between the CDMR and planned vaginal delivery groups in the frequencies of maternal intensive care unit admission (0.2% vs 0.2%), severe postpartum hemorrhage (0.5% vs 0.5%), maternal infection (1.3% vs 1.3%), organ injuries (0.4‰ vs 0.5‰), and thromboembolic disorders (0.1‰ vs 0.1‰). The perinatal mortality rate was similar in the 2 groups (0.4‰ vs 0.6‰; adjusted odds ratio, 0.51; 95% confidence interval, 0.20-1.30; P = .159). The frequencies of birth trauma (0.2‰ vs 1.1‰), neonatal infection (0.4% vs 0.7%), hypoxic ischemicencephalopathy (0.4‰ vs 1.8‰), and meconium aspiration syndrome (0.2‰ vs 0.6‰) were lower; the frequency of respiratory-distress syndrome (0.6% vs 0.4%) was higher in the CDMR group. CONCLUSION: Compared with nulliparous women who tried vaginal delivery, women who underwent CDMR had similar short-term maternal outcomes with some neonatal benefit.
Authors: Yanfang Guo; Malia S Q Murphy; Erica Erwin; Romina Fakhraei; Daniel J Corsi; Ruth Rennicks White; Alysha L J Harvey; Laura M Gaudet; Mark C Walker; Shi Wu Wen; Darine El-Chaâr Journal: CMAJ Date: 2021-05-03 Impact factor: 8.262
Authors: Lianlian Wang; Xianglong Xu; Philip Baker; Chao Tong; Lei Zhang; Hongbo Qi; Yong Zhao Journal: Int J Environ Res Public Health Date: 2016-07-07 Impact factor: 3.390