不同分娩方式对产妇产后出血及新生儿免疫功能的影响

摘要

目的 探讨阴道分娩与剖宫产对产后出血及新生儿免疫功能的影响.方法 选择健康初产妇120例,按照选择分娩方式的不同分为阴道分娩组和剖宫产组,每组各60例.检测两组产妇产后出血情况以及新生儿Apgar评分,脐带血免疫球蛋白(IgA、IgG和IgM)及C-反应蛋白(CRP)的变化水平.结果 剖宫分娩的产后出血率显著高于阴道分娩组(P＜ 0.05),而分娩方式对新生儿1 min和5 min Apgar评分结果并无显著影响(P＞0.05).剖宫产组IgA、CRP水平显著高于阴道分娩(P＜0.05),而IgG、IgM水平则低于阴道分娩组(P＜0.05),且剖宫产男性新生儿IgA和IgM水平明显低于女性新生儿,IgG水平则高于女性新生儿,差异均有统计学意义(P＜0.05).结论 阴道分娩与剖宫产对新生儿的Apgar评分无明显的影响,但剖宫产术可导致产后出血率增加并降低新生儿免疫力.%Objective To explore the vaginal delivery and cesarean section on the postpartum hemorrhage,Apgar score of newborns,and immune function by the primiparous women.Methods 120 cases of pregnant women were divided into vaginal delivery and cesarean section group,60 cases in each group.Apgar score,immunoglobulin (IgA,IgG and IgM) and C-reactive protein (CRP) level,and the levels of postpartum hemorrhage were detected in the two groups of newborns.Results The vaginal delivery mode showed significant lower rate of postpartum hemorrhage (P ＜ 0.05).There were no significant differences on the 1 min and 5 min Apgar score results between the two groups (P =0.17; P=0.50).IgA,CRP level was significantly higher in cesarean section group than that of vaginal delivery group (P ＜0.05),while IgG,IgM level was lower than that of the vaginal delivery group (P ＜ 0.05).Male newborns IgA and IgM levels were significantly lower in female newborns,but IgG was higher than the female newborns in the cesarean group (P ＜ 0.05).Conclusion Vaginal delivery and cesarean have no significant effects on neonatal Apgar score,bat cesarean section can result in the decreased immunity and high rate of postpartum hemorrhage.