Effects of different modes of delivery on maternal and perinatal outcomes in low-risk puerperant

Objective To investigate the effects of vaginal delivery and cesarean section on maternal and perinatal outcomes in low-risk puerperant. Methods 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. Results 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). Conclusions 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. Key words: Vaginal delivery; Cesarean section; Perinatal outcome; Postpartum hemorrhage; Immunologic function