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世界核心医学期刊文摘（妇产科学分册） 2005年第5期1卷 16-17页

作者： sheiner e Levy A Katz M Mazor M 张超

The purpose of the present study was to examine the association between sponta neous consecutive recurrent abortions and pregnancy complications such as hypert ensive disorders, abruptio placenta, intrauterine growth restriction and cesarea n section (CS) in the subsequent pregnancy. A population-based study comparing all singleton pregnancies in women with and without two or more consecutive recu rrent abortions was conducted. Deliveries occurred during the years 1988-2002. Stratified analysis, using a multiple logistic regression model was performed to control for confounders. During the study period 154,294 singleton deliveries o ccurred, with 4.9%in patients with history of recurrent consecutive abortions. Using a multivariate analysis, with backward elimination, the following complica tions were significantly associated with recurrent abortions advanced maternal a ge, cervical incompetence, previous CS, diabetes mellitus, hypertensive disorder s, placenta previa and abruptio placenta, mal-presentations and PROM. A higher rate of CS was found among patients with previous spontaneous consecutive recurr ent abortions (15.9%versus 10.9%; OR = 1.6; 95%CI, 1.5-1.7; P er multivariate analysis was performed, with CS as the outcome variable, control ling for confounders such as placenta previa, abruptio placenta, diabetes mellit us, hypertensive disorders, previous CS, mal-presenta-tions, fertility treatme nts and PROM. A history of recurrent abortion was found as an independent risk f actor for CS (OR = 1.2; 95%CI, 1.1-1.3; P es of inherite d thrombophilia were found between the years 2000-2002. These cases were signif icantly more common in the recurrent abortion as compared to the comparison grou p (1.2%versus 0.1%; OR = 11.1; 95%CI, 6.5-18.9; P exists between consecutive recurrent abortions and pregnancy complicat ions such as placental abruption, hypertensive disorders and CS. This associatio

关键词：自然流产妊娠结局胎盘早剥复发性流产单胎妊娠前置胎盘妊娠并发症血栓形成倾向辅助生殖高龄产妇

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肩难产相关决定因素的人群研究

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世界核心医学期刊文摘（妇产科学分册） 2006年第10期2卷 16-17页

作者： sheiner e. Levy A. Hershkovitz R. 张旸 Department of Obstetrics and Gynecology Faculty of Health Sciences Soroka University Medical Center Beer-Sheva Israel

Objective: The study was aimed to define obstetric factors associated with shoulder dystocia. Methods: A population-based study comparing all singleton, vertex, term deliveries with shoulder dystocia with deliveries without shoulder dystocia was performed. Statistical analysis was done using multiple logistic regression analysis. Results: Shoulder dystocia complicated 0.2%(n=245) of all deliveries included in the study(n=107965). Independent risk factors for shoulder dystocia in a multivariable analysis were birth-weight ≥4000 g(OR=24.3; 95%CI 18.5-31.8), vacuum delivery(OR=5.7, 95%CI 3.4-9.5), diabetes mellitus(OR=1.7, 95%CI 1.2-2.5) and lack of prenatal care(OR=1.5, 95%CI 1.1-2.3). A significant linear association was found between birth-weight and shoulder dystocia, using the Mantel-Haenszel procedure. Pregnancies complicated with shoulder dystocia had higher rates of third-degree perineal tears as compared to the comparison group (0.8%versus 0.1%; P erinatal mortality was higher among newborns delivered after shoulder dystocia as compared to the comparison group(3.7%versus 0.5%; OR=7.4, 95%CI 3.5-14.9, Pese newborns had higher rates of Apgar scores lower than 7 at 1 and 5 min as compared to newborns delivered without shoulder dystocia(29.7%versus 3.0%; OR=13.8, 95%CI 10.3-18.4, Persus 0.3%; OR=7.2, 95%CI 2.8-18.1, Pespectively). Combining risk factors such as large for gestational age, diabetes mellitus and vacuum delivery increased the risk for shoulder dystocia to 6.8%(OR=32.6, 95%CI 10.1-105.8, Pependent factors associated with shoulder dystocia were birth-weight ≥4000 g, vacuum delivery, diabetes mellitus and lack of prenatal care.

关键词：肩难产胎吸助产头先露足月分娩产科因素围生期死亡率会阴撕裂产前检查比较性线性相关

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炎症性肠病与早产

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世界核心医学期刊文摘（妇产科学分册） 2006年第1期2卷 52-53页

作者： elbaz G. FichA. Levy A. e. sheiner 张旸 Department of Obstetrics and Gynecology Soroka University Medical Center P.O. Box 151 Beer-Sheva Israel

The present study investigates pregnancy outcome in women with IBD and examines the effect of pregnancy on the severity of IBD. Method: A case-control study comparing deliveries by mothers with IBD between January 1988 and January 2005 was performed. For every birth by a mother with IBD, four births by non- IBD mothers were randomly selected and adjusted for ethnicity and year of delivery. Result: During the study period there were 48 deliveries to patients with Crohn’ s disease and 79 deliveries to patients with ulcerative colitis. Higher rates of preterm delivery ( eeks) were found among patients with IBD as compared to the controls (odds ratios (OR) = 2.2; 95% confidence interval (CI) = 1.3- 3.8). This association remained significant after adjustment for labor induction and multiple gestations, using the Mantel-Haenszel technique (weighted OR = 2.1; 95% CI 1.3- 3.5 and weighted OR = 2.0; 95% CI 1.2- 3.5; P = 0.012; respectively). In addition, these patients had higher rates of fertility treatments (OR = 2.2; 95% CI = 1.1- 4.4). Using a multivariate analysis, controlling for maternal age and fertility treatments, preterm delivery was seen to be significantly associated with IBD (adjusted OR = 2.0; 95% CI = 1.2- 3.5). Perinatal outcomes, such as perinatal mortality, low Apgar scores, and congenital malformations, were comparable to the outcomes in the control group. Conclusion: Maternal IBD is an independent risk factor for preterm delivery. IBD is not associated with adverse perinatal outcome.

关键词：炎症性肠病 Mantel-Haenszel法早产低Apgar评分病例对照研究不良围生结局分娩情况溃疡性结肠炎 Crohn病围生儿死亡率

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肥胖手术治疗后合并妊娠期糖尿病孕妇的妊娠结局

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世界核心医学期刊文摘（妇产科学分册） 2006年第8期2卷 19-20页

作者： sheiner e. Menes T.S. Silverberg D. 吕涛 Department of Obstetrics and Gynecology Rush University Medical Center 1653 West Congress Parkway Chicago IL 60612 United States Dr.

Objective: The objective of the study was to investigate pregnancy outcome of patients with gestational diabetes mellitus following bariatric surgery. Study design: All births to patients with gestational diabetes mellitus delivered between the years 1988 and 2002 were included in the study. A comparison between patients with and without a history of bariatric surgery was performed. Stratified analyses, using the Mantel-Haenszel technique and a multiple logistic regression model were performed to control for confounders. Results: During the study period, there were 8014 deliveries of women with gestational diabetes mellitus. Twenty-eight were in patients following bariatric surgery. Most patients underwent restrictive (n = 26) and not malabsorptive procedures (n = 2), mainly gastric banding (n = 16). Mean levels of hemoglobin A1c and fasting glucose were comparable between the groups. No significant differences in obstetric characteristics or pregnancy outcomes were noted between the patients following bariatric surgery as compared with the comparison group, except for higher rates of fertility treatments (21.4% versus 5.5% ; P e controlling for nulliparity and maternal age, using a multivariable analysis, a significant association was noted between bariatric surgery and fertility treatments (odds ratios 4.7; 95% confidence interval 1.9 to 11.7; P = .001). Perinatal outcome was comparable between the groups, and no significant differences were noted with regard to complications such as perinatal mortality, congenital malformations, and low Apgar scores at 1 and 5 minutes. Conclusion: Previous bariatric surgery in patients with gestational diabetes mellitus is not associated with adverse perinatal outcome.

关键词：妊娠结局妊娠期糖尿病产科情况空腹血糖水平围生期围生儿死亡率妇女分娩吸收不良先天畸形

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有先兆子痫病史女性的动脉粥样硬化长期发病率

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中华高血压杂志 2015年第1期23卷 99-99页

作者： Kessous R Shoham-Vardi I Pariente G Sergienko R sheiner e 刘莉叶鹏

该研究旨在确定重度及复发先兆子痫是否增加母亲长期动脉粥样硬化性疾病的发生风险。方法：进行一项以人口为基础的研究，比较1988—2012年分娩的女性队列中长期动脉粥样硬化的发病率。研究变量为先兆子痫。平均随访时间为11．2年。

关键词：动脉粥样硬化性疾病先兆子痫发病率女性病史发生风险随访时间

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孕妇临床表现明显的子宫平滑肌瘤与宫缩过频的高发率相关

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世界核心医学期刊文摘（妇产科学分册） 2005年第2期1卷 21-21页

作者： sheiner e. Biderman-Madar T. Katz M. 石磊

This study was undertaken to determi ne uterine and fetal heart rate(FHR)tracing patterns associated with clinically apparent uterine *** and FHR patterns of44women with diagnosed uterine leio myomas were com-pared with 601tracings of *** were inter-preted during the first stage of labor,using the National Institute of Child Health and Human Development Research Planning Workshop *** tified analysis that used the Mantel -Haenszel technique was p erformed to control for *** with leio myomas had higher rates of uterine tachysystole as compared with those without leiomyomas(22.7%vs 1.3%;odds ratioOR=21.8,95%CI 7.4-65.6;P er-ences were noted between the groups r egarding FHR *** rates’of prostaglandin induction and oxytocin augmentation were noted in the uterine leiomyomas group(6.8%vs 0.8%;P =.005and 52.3%vs 10.5%;Pespectively).However,controlling for prostag-landin induction and oxytocin augme ntation,with the use of the Mantel -Haenszel procedure,did not change the sig-nificant association between uterine leiomyomas and tachysystole(weighted OR 12.5,95%CI 6.2-75.1,an d weighted OR 8.7,95%CI 3.6-43.1,respectively).Clinically apparent uterine leiomy omas,although not cou-pled with abnormal FHR patterns,are associated with higher rates of tachysystole.

关键词：子宫平滑肌瘤高发率胎儿心率前列腺素引产胎心率第一产程混杂因素研究计划分析控制无显著性差异

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妊娠合并贫血是发生低出生体重及早产的独立危险因素

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世界核心医学期刊文摘（妇产科学分册） 2006年第2期2卷 17-17页

作者： Levy A. Fraser D. Katz M. e. sheiner 张剑萍 Department of Obstetrics and Gynecology Soroka University Medical Center Ben-Gurion University of the Negev P.O. Box 151 Beer-Sheva Israel

Objective: The present study was designed to investigate the outcome of pregnancy and delivery in patients with anemia. Methods: A retrospective population-based study comparing all singleton pregnancies of patients with and without anemia was performed. Deliveries occurred during the years 1988-2002 in the Soroka University Medical Center. Maternal anemia was defined as hemoglobin concentration lower than 10 g/dl during pregnancy. Patients with hemoglobinopathies such as thalassemia were excluded from the analysis. Multiple logistic regression models were performed to control for confounders. Results: During the study period there were 153,396 deliveries, of which 13,204 (8.6%) occurred in patients with anemia. In a multivariable analysis, the following conditions were significantly associated with maternal anemia: placental abruption, placenta previa, labor induction, previous cesarean section (CS), non-vertex presentation and Bedouin ethnicity. Higher rates of preterm deliveries (eeks gestation) and low birthweight (ere found among patients with anemia as compared to the non-anemic women (10.7%versus 9.0%, p ersus 9.4%, p espectively). Higher rates of CS were found among anemic women (20.4%versus 10.3%; p e significant association between anemia and low birthweight persisted after adjusting for gender, ethnicity and gestational age, using a multivariable analysis (OR = 1.1; 95%CI 1.0-1.2, p = 0.02). Two multivariable logistic regression models, with preterm delivery (eeks gestation) and low birthweight (e outcome variables, were constructed in order to control for possible confounders such as ethnicity, maternal age, placental problems, mode of delivery and non-vertex presentation. Maternal anemia was an independent risk factor for both, preterm delivery (OR = 1.2; 95%CI 1.1-1.2, p eight (OR = 1.1; 95%CI 1.1-1.2, p = 0.001). Conclusion: Maternal anemia influences

关键词：妊娠合并贫血顶先露胎盘早剥前次剖宫产单胎妊娠前置胎盘分娩结局孕期贫血胎方位地中海贫

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剖宫产伤口感染的危险因素

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世界核心医学期刊文摘（妇产科学分册） 2005年第12期1卷 54-54页

作者： Schneid-Kofman N. sheiner e. Levy A./Holcberg G. 李炜修 Department of Obstetrics and Gynecology Soroka University Medical Center P.O. Box 151 Beer-Sheva Israel

Objective: To identify risk factors for early wound infection (diagnosed prior to discharge) following cesarean delivery. Methods: A population-based study comparing women who have and have not developed a wound infection prior to discharge from Soroka University Medical Center, Ben Gurion University of the Negev, between 1988 and 2002. Results: Of the 19,416 cesarean deliveries performed during the study period, 726 (3.7% ) were followed by wound infection. Using a multivariable logistic regression model, the following risk factors were identified: obesity (odds ratio [OR] = 2.2; 95% confidence interval [CI], 1.6- 3.1); hypertensive disorders (OR = 1.7; 95% CI, 1.4- 2.1); premature rupture of membranes (OR = 1.5; 95% CI, 1.2- 1.9); diabetes mellitus (OR = 1.4; 95% CI, 1.1- 1.7); emergency cesarean delivery (OR = 1.3; 95% CI, 1.1- 1.5); and twin delivery (OR = 1.6; 95% CI, 1.3- 2.0). Combined obesity and diabetes (gestational and pregestational) increased the risk for wound infection 9.3- fold (95% CI, 4.5- 19.2; P ependent risk factors for an early wound infection are obesity, diabetes, hypertension, premature rupture of membranes, emergency cesarean delivery, and twin delivery. Information regarding higher rates of wound infection should be provided to obese women undergoing cesarean delivery, especially when diabetes coexists.

关键词：剖宫产伤口剖宫产术双胎妊娠急诊剖宫产胎膜早破伤口感染古里安内盖夫

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