选择性剖宫产与足月新生儿呼吸系统疾病风险相关性的荟萃分析

Correlation between elective cesarean section and risk of neonatal respiratory morbidity：a systematic review

摘要:

目的：评价选择性剖宫产（elective cesarean delivery，ECD）与足月新生儿呼吸系统疾病的发病风险的相关性。方法：用Meta分析方法，综合国内外有关ECD与足月新生儿呼吸系统疾病之间风险关系的观察性研究文献1２篇，采用随机效应模型，通过RevMan 5.0软件进行分析评价。结果：与阴道分娩组相比，ECD对足月新生儿呼吸系统疾病的发病率间有相关性[OR（95％CI）=3.43（2.18，5.14），P＝0.000]；而ECD与非ECD在新生儿呼吸系统发病风险间未见显著相关性[OR（95％CI）=1.97（0.98，3.92），P=0.06]。而对孕周而言，妊娠39周之前分娩的新生儿较39周以后者呼吸系统疾病的发病率明显增高[P＝0.000，OR（95％CI）=2.29（1.66，3.16）]。结论：Meta分析表明，ECD可增加新生儿呼吸系统疾病的发生率，而妊娠39周之前施行ECD较39周后新生儿呼吸系统发病率高。

Abstract:

Objective：To analyze the correlation between elective cesarean delivery（ECD） and the risk of neonatal respiratory morbidity by Meta analysis． Methods：Twelve observational studies on relationship between ECD and neonatal respiratory morbidity were re－viewed and analyzed in this study. Random effect model and RevMan 5.0 software were adopted to analyze the data． Results：There were statistical differences in respiratory morbidity of full-term neonates between ECD and vaginal delivery（OR（95%CI）=3.43（2.18，5.14），P＝0.000）. There was no significant correlation in risk for neonatal respiratory disease between ECD and emergency cesarean section（OR（95%CI）=1.97（0.98，3.92），P=0.06）. Respiratory morbidity was significantly increased in neonates born after the 39th gestational week than in neonates born before the 39th gestational week（P＝0.000，OR（95%CI）=2.29（1.66，3.16））. Conclusions：ECD may associate with the risk of neonatal respiratory morbidity.Respiratory morbidity is higher in neonates born after the 39th gestational week than in neonates born before the 39th gestational week.