Objective: Concerns remain about the safety and efficacy of high dose and low dose protocols of oxytocin for labor induction. We have compared 2 regimens of oxytocin induction (low-dose vs high dose) on perinatal outc...Objective: Concerns remain about the safety and efficacy of high dose and low dose protocols of oxytocin for labor induction. We have compared 2 regimens of oxytocin induction (low-dose vs high dose) on perinatal outcomes over a 1-year period. Study Design: Included were all women undergoing induction of labor at term with live singleton gestations. Cesarean delivery (CD) and a composite adverse neonatal outcome (5-min Apgar score < 7, umbilical artery pH < 7.10, or need for admission to NICU) were assessed using logistic regression analysis. Admission-to-delivery intervals was compared between the two groups by log-rank test. Results: A total of 544 women fulfilled the study criteria. The two groups were comparable for demographic and obstetric variables. There was no significant association between oxytocin regimen and rates of CD (P = 0.77) or adverse neonatal outcome (P = 0.99) even after controlling for confounders. The admission-to-delivery interval was significantly shorter for the high-dose group than for the low-dose group (median interval = 11.7 vs 14.3 hours, respectively, P = 0.026). Conclusion: Use of a high-dose protocol of oxytocin administration for induction of labor at term is associated with similar rates of cesarean section and adverse neonatal outcome as a low-dose protocol, but with an average of 2.5 hours shorter duration of labor.展开更多
Couples are escalating delay in childbearing to the late 35 s (female), the 40 s (males) and afar. The surmising of this collective and societal transformation on youth constitution and salubriousness has just at pres...Couples are escalating delay in childbearing to the late 35 s (female), the 40 s (males) and afar. The surmising of this collective and societal transformation on youth constitution and salubriousness has just at present been a spotlight of research. There are distinguished intensified perinatal risks related with expanding maternal age, notwithstanding the way that fatherly age seems to have a presumably predominant adverse impingement on youth well-being. Although the preeminent rate of poor gravidness consequence may contrast from individual to singular point of view, the impingement of postponing childbearing from a general wellbeing perspective cannot be swelled and should be in the pattern of general wellbeing plan for the coming years. Recognizing the part of components and black box, characteristically the maturing of the gametes, and how this change effects on preparation, blastulation lastly the posterity, is an essential and consequent advance as we attempt to help patients outline sound families.展开更多
目的:探讨妊娠期糖尿病(GDM)孕妇新生儿不良结局高危因素并建立logistic风险模型。方法:选取2020年2月-2022年8月本院产科门诊接收的GDM孕妇196例临床资料,依据新生儿结局分为不良组、良好组。采用logistic回归分析明确GDM孕妇发生不良...目的:探讨妊娠期糖尿病(GDM)孕妇新生儿不良结局高危因素并建立logistic风险模型。方法:选取2020年2月-2022年8月本院产科门诊接收的GDM孕妇196例临床资料,依据新生儿结局分为不良组、良好组。采用logistic回归分析明确GDM孕妇发生不良新生儿结局高危因素,建立logistic风险模型,采用Hosmer-Lemeshow检验判定风险模型拟合优度,受试者工作特征(ROC)曲线探讨风险模型的预测效力。结果:最终纳入的168例孕妇中出现不良新生儿结局44例、未出现124例。不良组与良好组妊娠期高血压疾病、抑郁症状、孕前BMI、孕期增重情况、空腹血糖(FPG)、服糖后1 h血糖(1 h PG)、分娩前糖化血红蛋白(HbA1c)有差异;logistic回归分析显示,妊娠期高血压疾病、抑郁症状、孕期增重过度、分娩前HbA1c水平高均为GDM孕妇发生不良新生儿结局独立危险因素(均P<0.05)。基于独立危险因素建立logistic风险模型,Logit(P)=-15.610+1.472×妊娠期高血压疾病(有=1,无=0)+0.884×抑郁症状(有=1,无=0)+1.014×孕期增重情况(孕期增重过度=2,孕期增重不足=1,孕期增重正常=0)+2.053×分娩前HbA1c(%),Hosmer-Lemeshow检验(χ^(2)=9.952,P=0.268)拟合优度良好。ROC曲线显示,logistic风险模型预测GDM孕妇发生不良新生儿结局的曲线下面积为0.792,95%CI 0.707~0.877,最佳预测敏感度77.3%,预测特异度72.6%。结论:GDM孕妇不良新生儿结局高危因素包括妊娠期高血压疾病、抑郁症状、孕期增重过度、分娩前HbA1c水平高,应用其建立的logistic风险模型预测效力较好,为临床干预提供参考。展开更多
文摘Objective: Concerns remain about the safety and efficacy of high dose and low dose protocols of oxytocin for labor induction. We have compared 2 regimens of oxytocin induction (low-dose vs high dose) on perinatal outcomes over a 1-year period. Study Design: Included were all women undergoing induction of labor at term with live singleton gestations. Cesarean delivery (CD) and a composite adverse neonatal outcome (5-min Apgar score < 7, umbilical artery pH < 7.10, or need for admission to NICU) were assessed using logistic regression analysis. Admission-to-delivery intervals was compared between the two groups by log-rank test. Results: A total of 544 women fulfilled the study criteria. The two groups were comparable for demographic and obstetric variables. There was no significant association between oxytocin regimen and rates of CD (P = 0.77) or adverse neonatal outcome (P = 0.99) even after controlling for confounders. The admission-to-delivery interval was significantly shorter for the high-dose group than for the low-dose group (median interval = 11.7 vs 14.3 hours, respectively, P = 0.026). Conclusion: Use of a high-dose protocol of oxytocin administration for induction of labor at term is associated with similar rates of cesarean section and adverse neonatal outcome as a low-dose protocol, but with an average of 2.5 hours shorter duration of labor.
文摘Couples are escalating delay in childbearing to the late 35 s (female), the 40 s (males) and afar. The surmising of this collective and societal transformation on youth constitution and salubriousness has just at present been a spotlight of research. There are distinguished intensified perinatal risks related with expanding maternal age, notwithstanding the way that fatherly age seems to have a presumably predominant adverse impingement on youth well-being. Although the preeminent rate of poor gravidness consequence may contrast from individual to singular point of view, the impingement of postponing childbearing from a general wellbeing perspective cannot be swelled and should be in the pattern of general wellbeing plan for the coming years. Recognizing the part of components and black box, characteristically the maturing of the gametes, and how this change effects on preparation, blastulation lastly the posterity, is an essential and consequent advance as we attempt to help patients outline sound families.
文摘目的:探讨妊娠期糖尿病(GDM)孕妇新生儿不良结局高危因素并建立logistic风险模型。方法:选取2020年2月-2022年8月本院产科门诊接收的GDM孕妇196例临床资料,依据新生儿结局分为不良组、良好组。采用logistic回归分析明确GDM孕妇发生不良新生儿结局高危因素,建立logistic风险模型,采用Hosmer-Lemeshow检验判定风险模型拟合优度,受试者工作特征(ROC)曲线探讨风险模型的预测效力。结果:最终纳入的168例孕妇中出现不良新生儿结局44例、未出现124例。不良组与良好组妊娠期高血压疾病、抑郁症状、孕前BMI、孕期增重情况、空腹血糖(FPG)、服糖后1 h血糖(1 h PG)、分娩前糖化血红蛋白(HbA1c)有差异;logistic回归分析显示,妊娠期高血压疾病、抑郁症状、孕期增重过度、分娩前HbA1c水平高均为GDM孕妇发生不良新生儿结局独立危险因素(均P<0.05)。基于独立危险因素建立logistic风险模型,Logit(P)=-15.610+1.472×妊娠期高血压疾病(有=1,无=0)+0.884×抑郁症状(有=1,无=0)+1.014×孕期增重情况(孕期增重过度=2,孕期增重不足=1,孕期增重正常=0)+2.053×分娩前HbA1c(%),Hosmer-Lemeshow检验(χ^(2)=9.952,P=0.268)拟合优度良好。ROC曲线显示,logistic风险模型预测GDM孕妇发生不良新生儿结局的曲线下面积为0.792,95%CI 0.707~0.877,最佳预测敏感度77.3%,预测特异度72.6%。结论:GDM孕妇不良新生儿结局高危因素包括妊娠期高血压疾病、抑郁症状、孕期增重过度、分娩前HbA1c水平高,应用其建立的logistic风险模型预测效力较好,为临床干预提供参考。
