当前位置： SCI文献检索 > OBSTETRICS AND GYNECOLOGY期刊下所有文献 > Association between obstetrician forceps volume and maternal and neonatal outcomes.

Association between obstetrician forceps volume and maternal and neonatal outcomes.

Abstract：

OBJECTIVE:To estimate the association between obstetric forceps volume and severe perineal lacerations or adverse neonatal outcomes. METHODS:This is a retrospective cohort of forceps deliveries performed at a tertiary care hospital. Obstetricians were grouped by quartile of forceps volume over the study time period. Severe (third- or fourth-degree) perineal lacerations and adverse neonatal outcomes were compared across quartiles. Individual patient characteristics were controlled for using multilevel multivariable analysis. This study had 90% power to detect a twofold difference in severe perineal lacerations between the first and fourth quartiles. Additional analyses were performed using physician years in practice or year of residency of the involved resident physicians. RESULTS:One hundred eighteen attending physicians (2,369 forceps deliveries) were included. The median (interquartile range) annual number of forceps per quartile was 1.3 (1.0-1.8), 3.8 (3.0-4.3), 6.3 (5.5-6.8), and 11.5 (9.8-17.3). The frequency of severe perineal lacerations from lowest to highest quartile was 29.9%, 27.5%, 33.3%, and 36.9% (P=.013). After adjusting for confounders, the relationship between volume quartile and severe perineal lacerations became nonsignificant. Although not powered to this outcome, the frequency of composite adverse neonatal outcome was not associated with volume quartile in either bivariate or multivariable analysis. Similarly, neither physician years of practice nor resident year was associated with severe perineal laceration. However, more experience as a resident was associated with a reduced odds of composite adverse neonatal outcomes. CONCLUSIONS:After controlling for patient factors, neither attending forceps volume nor physician years in practice was associated with severe perineal lacerations or composite neonatal injury. LEVEL OF EVIDENCE:II.

journal_name

Obstet Gynecol

journal_title

Obstetrics and gynecology

authors

Miller ES,Barber EL,McDonald KD,Gossett DR

doi

10.1097/AOG.0000000000000096

subject

Has Abstract

pub_date

2014-02-01 00:00:00

pages

248-254

issue

2 Pt 1

eissn

0029-7844

issn

1873-233X

pii

00006250-201402000-00005

journal_volume

123

pub_type

杂志文章

在线工具

Association between obstetrician forceps volume and maternal and neonatal outcomes.