PDF(Pubmed)
Abstract：
BACKGROUND: The white blood cell count is often used to assess the maternal condition after an operative vaginal delivery. However, it remains unknown whether the maternal white blood cell count on the day after delivery is associated with sequential maternal adverse outcomes, especially infectious complications. The aim of this study was to investigate the association between maternal white blood cell count on the day after operative vaginal delivery and sequential maternal adverse events.
METHODS: The study was a retrospective cohort study using the Medical Data Vision claims database containing administrative claims data, discharge abstracts, and laboratory values in Japan. We identified all patients who underwent operative vaginal delivery with data on maternal white blood cell count from December 2011 to November 2020. The main composite outcome was maternal adverse outcomes, comprising additional treatment for maternal injuries, postpartum intravenous antibiotic use, and intensive care unit use during hospitalization. We conducted a restricted cubic spline analysis to investigate the nonlinear association between white blood cell count and the primary outcome.
RESULTS: There were 485 eligible patients including 73 patients with occurrence of the primary outcome. The median (interquartile range) white blood cell count on the day after delivery in all eligible women was 15,170 (12,610-18,300)/mL. In the restricted cubic spline analysis, there was no significant association of white blood cell count with the primary outcome.
CONCLUSIONS: White blood cell count on the day after operative vaginal delivery was not significantly associated with maternal adverse outcomes during hospitalization.
METHODS: The study was a retrospective cohort study using the Medical Data Vision claims database containing administrative claims data, discharge abstracts, and laboratory values in Japan. We identified all patients who underwent operative vaginal delivery with data on maternal white blood cell count from December 2011 to November 2020. The main composite outcome was maternal adverse outcomes, comprising additional treatment for maternal injuries, postpartum intravenous antibiotic use, and intensive care unit use during hospitalization. We conducted a restricted cubic spline analysis to investigate the nonlinear association between white blood cell count and the primary outcome.
RESULTS: There were 485 eligible patients including 73 patients with occurrence of the primary outcome. The median (interquartile range) white blood cell count on the day after delivery in all eligible women was 15,170 (12,610-18,300)/mL. In the restricted cubic spline analysis, there was no significant association of white blood cell count with the primary outcome.
CONCLUSIONS: White blood cell count on the day after operative vaginal delivery was not significantly associated with maternal adverse outcomes during hospitalization.
摘要：
背景：白细胞计数通常用于评估手术阴道分娩后的母体状况。然而,目前尚不清楚分娩后当天的母体白细胞计数是否与相继的母体不良结局有关,尤其是感染性并发症.这项研究的目的是调查手术阴道分娩后当天的母体白细胞计数与随后的母体不良事件之间的关系。
方法：该研究是一项回顾性队列研究，使用包含行政索赔数据的医疗数据视觉索赔数据库，出院摘要，和日本的实验室价值。从2011年12月至2020年11月，我们使用母体白细胞计数数据确定了所有接受手术阴道分娩的患者。主要复合结局为产妇不良结局,包括对产妇受伤的额外治疗，产后静脉注射抗生素的使用，以及住院期间使用重症监护室。我们进行了有限的三次样条分析，以研究白细胞计数与主要结果之间的非线性关联。
结果：有485名合格患者，其中73名患者出现主要结局。所有符合条件的妇女分娩后当天的白细胞计数中位数（四分位距）为15,170（12,610-18,300）/mL。在受限三次样条分析中，白细胞计数与主要结局无显著相关性.
结论：阴道分娩术后当天的白细胞计数与住院期间的产妇不良结局无显著相关。
方法：该研究是一项回顾性队列研究，使用包含行政索赔数据的医疗数据视觉索赔数据库，出院摘要，和日本的实验室价值。从2011年12月至2020年11月，我们使用母体白细胞计数数据确定了所有接受手术阴道分娩的患者。主要复合结局为产妇不良结局,包括对产妇受伤的额外治疗，产后静脉注射抗生素的使用，以及住院期间使用重症监护室。我们进行了有限的三次样条分析，以研究白细胞计数与主要结果之间的非线性关联。
结果：有485名合格患者，其中73名患者出现主要结局。所有符合条件的妇女分娩后当天的白细胞计数中位数（四分位距）为15,170（12,610-18,300）/mL。在受限三次样条分析中，白细胞计数与主要结局无显著相关性.
结论：阴道分娩术后当天的白细胞计数与住院期间的产妇不良结局无显著相关。
