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Created on : 03 Apr 2018
Modified on : 28 Jun 2018

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Bibliographical entry (without author) :

The effect of medical and operative birth interventions on child health outcomes in the first 28 days and up to 5 years of age: A linked data population‐based cohort study. Birth.

Author(s) :

Peters, Lilian L., Charlene Thornton, Ank de Jonge, Ali Khashan, Mark Tracy, Soo Downe, Esther I. Feijen‐de Jong, and Hannah G. Dahlen.

Year of publication :

2018

URL(s) :

https://onlinelibrary.wiley.com/doi/full/10.1111/b…
https://doi.org/10.1111/birt.12348

Résumé (français)  :

Contexte

Les taux spontanés de natalité vaginale diminuent dans le monde entier, tandis que les accouchements par césarienne, les accouchements instrumentaux et les interventions médicales obstétricales sont en augmentation. Des données émergentes suggèrent que les interventions à la naissance peuvent avoir un effet sur la santé des enfants. Par conséquent, le but de notre étude était d’examiner l’association entre les interventions chirurgicales et médicales de naissance sur la santé de l’enfant pendant les 28 premiers jours et jusqu’à 5 ans.
Méthodes

En Nouvelle-Galles du Sud (Australie), des ensembles de données liées à la population ont été analysés, notamment les caractéristiques maternelles, les caractéristiques des enfants, le mode de naissance, les interventions pendant le travail et l’accouchement et les problèmes de santé des enfants. l’hypothermie, l’asthme, les infections respiratoires, les troubles gastro-intestinaux, les autres infections, les troubles métaboliques et l’eczéma) enregistrés auprès de la Classification statistique internationale des maladies et des problèmes de santé connexes, dixième révision, codes de modification australiens. Des analyses de régression logistique ont été effectuées pour chaque effet indésirable sur la santé.
Résultats

Nos analyses ont inclus 491 590 femmes et leurs enfants; de ces 38% ont connu une naissance vaginale spontanée. Les nourrissons ayant eu une naissance instrumentale après l’induction ou l’augmentation présentaient le risque le plus élevé de jaunisse, odds ratio ajusté (RCa) 2,75 (intervalle de confiance à 95% [IC]: 2,61-2,91) comparativement à l’accouchement spontané par voie vaginale. Les enfants nés par accouchement par césarienne présentaient particulièrement un risque statistiquement significatif d’infections, d’eczéma et de troubles métaboliques, comparativement à l’accouchement spontané par voie vaginale. Les enfants nés par césarienne d’urgence ont montré la plus forte association pour le trouble métabolique, aOR 2,63 (IC à 95% 2,26-3,07).
Conclusion

Les enfants nés par accouchement spontané par voie vaginale avaient moins de problèmes de santé à court et à long terme, comparativement à ceux nés après des interventions à la naissance.

Abstract (English)  :

Background

Spontaneous vaginal birth rates are decreasing worldwide, while cesarean delivery, instrumental births, and medical birth interventions are increasing. Emerging evidence suggests that birth interventions may have an effect on children’s health. Therefore, the aim of our study was to examine the association between operative and medical birth interventions on the child’s health during the first 28 days and up to 5 years of age.
Methods

In New South Wales (Australia), population‐linked data sets were analyzed, including data on maternal characteristics, child characteristics, mode of birth, interventions during labor and birth, and adverse health outcomes of the children (ie, jaundice, feeding problems, hypothermia, asthma, respiratory infections, gastrointestinal disorders, other infections, metabolic disorder, and eczema) registered with the International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, Australian Modification codes. Logistic regression analyses were performed for each adverse health outcome.
Results

Our analyses included 491 590 women and their children; of those 38% experienced a spontaneous vaginal birth. Infants who experienced an instrumental birth after induction or augmentation had the highest risk of jaundice, adjusted odds ratio (aOR) 2.75 (95% confidence interval [CI] 2.61‐2.91) compared with spontaneous vaginal birth. Children born by cesarean delivery were particularly at statistically significantly increased risk for infections, eczema, and metabolic disorder, compared with spontaneous vaginal birth. Children born by emergency cesarean delivery showed the highest association for metabolic disorder, aOR 2.63 (95% CI 2.26‐3.07).
Conclusion

Children born by spontaneous vaginal birth had fewer short‐ and longer‐term health problems, compared with those born after birth interventions.

Sumário (português)  :

fundo

As taxas de parto vaginal espontâneo estão diminuindo em todo o mundo, enquanto o parto cesáreo, nascimentos instrumentais e intervenções em partos médicos estão aumentando. Evidências emergentes sugerem que as intervenções no parto podem ter um efeito sobre a saúde das crianças. Portanto, o objetivo do nosso estudo foi examinar a associação entre intervenções cirúrgicas e partos médicos na saúde da criança durante os primeiros 28 dias e até 5 anos de idade.
Métodos

Em New South Wales (Austrália), foram analisados ​​conjuntos de dados ligados à população, incluindo dados sobre características maternas, características da criança, modo de parto, intervenções durante o trabalho de parto e parto e desfechos adversos à saúde das crianças (isto é, icterícia, problemas alimentares, hipotermia, asma, infecções respiratórias, distúrbios gastrointestinais, outras infecções, distúrbios metabólicos e eczema) registrados na Classificação Estatística Internacional de Doenças e Problemas Relacionados à Saúde, Décima Revisão, códigos australianos de modificação. Análises de regressão logística foram realizadas para cada desfecho adverso à saúde.
Resultados

Nossas análises incluíram 491 590 mulheres e seus filhos; desses 38% tiveram um parto vaginal espontâneo. Os bebês que tiveram um parto instrumental após a indução ou aumento apresentaram o maior risco de icterícia, odds ratio ajustada (ORa) 2,75 (intervalo de confiança de 95% [IC] 2,61‐2,91) em comparação com o parto vaginal espontâneo. As crianças nascidas por parto cesáreo estavam particularmente em risco estatisticamente significativo de aumento de infecções, eczema e distúrbios metabólicos, em comparação com o parto vaginal espontâneo. As crianças nascidas por cesárea de emergência apresentaram a maior associação para distúrbio metabólico, aor 2,63 (IC 95% 2,26‐3,07).
Conclusão

As crianças nascidas por parto vaginal espontâneo tiveram menos problemas de saúde a curto e longo prazo, em comparação com as nascidas após as intervenções no parto.

Resumen (español)  :

Full text (public) :

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Argument (français) :

Les enfants nés par accouchement spontané par voie vaginale avaient moins de problèmes de santé à court et à long terme, comparativement à ceux nés après des interventions à la naissance.

Argument (English):

Children born by spontaneous vaginal birth had fewer short‐ and longer‐term health problems, compared with those born after birth interventions.

Argumento (português):

As crianças nascidas por parto vaginal espontâneo tiveram menos problemas de saúde a curto e longo prazo, em comparação com as nascidas após as intervenções no parto.

Argumento (español):

Keywords :

➡ c-section/caesarean ; ethics ; evidence-based medicine/midwifery ; iatrogeny ; newborn care ; public health ; vaginal birth after caesarean ; induction of labor ; instrumental delivery ; vacuum extraction (ventouse)

Author of this record :

Veronica Graham — 03 Apr 2018
➡ latest update : Bernard Bel — 28 Jun 2018