探讨经阴道与剖宫产分娩，对低危产妇母婴围生期结局的影响。

选取2014年12月，至2015年12月于第三军医大学西南第一附属医院产科住院分娩的948例低危产妇为研究对象。按照低危产妇分娩方式，将其分为阴道分娩组(n＝474，采用经阴道自然分娩方式)和剖宫产分娩组(n＝474，采用子宫下段剖宫产术分娩)。统计学比较2组产妇产后24 h出血量、产后出血(PPH)发生率、新生儿Apgar评分、新生儿窒息发生率和新生儿脐带血免疫球蛋白(Ig)A、G、M及C反应蛋白(CRP)水平等免疫功能指标。本研究通过医院伦理委员会审查，并与所有产妇及其家属均签署知情同意书。

①2组产妇年龄、孕龄，以及其分娩新生儿的体重、性别构成比等一般临床资料比较，差异均无统计学意义(P>0.05)。②阴道分娩组产妇产后24 h出血量及PPH发生率均低于剖宫产分娩组，差异均有统计学意义(t＝7.261，P＝0.016；χ²＝4.934，P＝0.021)。③2组产妇分娩新生儿出生1、5 min时，Apgar评分、窒息发生率分别比较，差异均无统计学意义(P>0.05)。阴道分娩组产妇分娩新生儿的脐带血IgG、IgM水平，均显著高于剖宫产分娩组，CRP水平则显著低于剖宫产分娩组，差异均有统计学意义(t＝2.973，P＝0.043；t＝3.755，P＝0.039；t＝4.825，P＝0.006)。2组产妇分娩新生儿的脐带血IgA水平比较，差异无统计学意义(P>0.05)。剖宫产分娩组产妇所分娩新生儿中，男性新生儿脐带血IgG水平显著低于女性新生儿，差异有统计学意义(t＝3.852，P＝0.040)；男、女性新生儿脐带血IgA、IgM、CRP水平，以及阴道分娩组产妇所分娩的男、女性新生儿脐带血IgA、IgG、IgM、CRP水平分别比较，差异均无统计学意义(P>0.05)。

阴道分娩较剖宫产分娩可减少低危产妇产后24 h出血量，降低PPH发生率，提高新生儿免疫功能，利于母婴健康。

To investigate the effects of vaginal delivery and cesarean section on maternal and perinatal outcomes in low-risk puerperant.

A total of 948 cases of low-risk puerperant delivering in the labor room of Southwest Hospital, First Affiliated Hospital of the Third Military Medical University from December 2014 to December 2015 were studied. According to the modes of delivery, they were divided into vaginal delivery group (n=474) and cesarean section group (n=474). Termination of pregnancy was done by vaginal spontaneous labor in vaginal delivery group and by lower segment cesarean section in cesarean section group. The amount of bleeding within 24 h after birth, incidence of postpartum hemorrhage (PPH), Apgar score of newborns, incidence of neonatal asphyxia and the levels of immunoglobulin (Ig)A, IgG, IgM and C-reactive protein (CPR) in newborns′ cord blood were statistically compared. Process of this study followed the standard of ethics formulated by committee on human trials in Southwest Hospital, First Affiliated Hospital of the Third Military Medical University. All puerperants and their families signed the informed consent before study.

①There were no statistically significant differences between two groups in maternal age, gestational age, birth weight of newborns and constituent ratio of newborns gender and so on (P>0.05). ②The amount of bleeding within 24 h after birth and the incidence of PPH in vaginal delivery group both were significantly lower than those in cesarean section group, and both the differences were statistically significant (t=7.261, P=0.016; χ²=4.934, P=0.021). ③There were no statistically significant differences between two groups in Apgar score of newborns and incidence of neonatal asphyxia at 1 min or 5 min after birth (P>0.05). The levels of IgG and IgM in cord blood of newborns in vaginal delivery group both were significantly higher than those in cesarean section group, and the level of CRP was significantly lower than that in cesarean section group, and all the differences were statistically significant (t=2.973, P=0.043; t=3.755, P=0.039; t=4.825, P=0.006). There was no statistically significant difference between two groups in the level of IgA in cord blood of newborns (P>0.05). In cesarean section group, the level of IgG in cord blood between male newborns was significantly lower than that of female newborns, and the difference was statistically significant (t=3.852, P=0.040), but there were no statistically significant differences between male and female newborns in the levels of IgA, IgM and CRP (P>0.05). In vaginal delivery group, there were no statistically significant differences in the levels of IgA, IgG, IgM and CRP in cord blood between male and female newborns (P>0.05).

Compared with cesarean section, vaginal delivery can reduce the amount of bleeding within 24 h after birth and the incidence of PPH, strengthen immunologic function of newborns, and it is good for maternal and fetal health in low-risk puerperant.