Effects of neuraxial labor analgesia on children: a review

背景 分娩疼痛程度剧烈,可对产妇及胎儿产生一系列不良影响.椎管内分娩镇痛是目前国内外应用最为普遍的分娩镇痛方法. 目的 回顾椎管内分娩镇痛对儿童影响的研究文献. 内容 椎管内分娩镇痛可以改善新生儿的状态(包括提高新生儿Apgar评分、改善新生儿酸碱平衡状态),这可能有利于儿童的远期发育,但还有待进一步的临床研究证实.椎管内分娩镇痛增加产妇发热的发生,这并不增加新生儿感染的发生,但会对新生儿产生不良的影响.已有的研究未能发现分娩镇痛药物对儿童脑发育有不良影响,也未发现剖宫产能改善儿童智力发育或器械助产能导致儿童远期神经发育迟缓. 趋向 目前的结果未发现椎管内分娩镇痛对儿童有不良的影响,这方面仍有待进一步研究.Background Labor pain is one of the most severe pains that a woman encounters during her life time.And it produces a series of adverse effects on both mother and child.Neuraxial labor analgesia is the most commonly used method of labor analgesia.Objective To review the effects of neuraxial labor analgesia on children.Content Neuraxial analgesia improved the neonatal status (including higher Apgar score,ameliorated acid-base balance),which might be favorable for children's long-term neurodevelopment.The later effect,however,deserves further confirmation.Neuraxial analgesia increased the occurrence of maternal fever during delivery which might have adverse effects on the newborn.However,it did not increase the rate of neonatal infection.Current evidence had not find that drugs used during labor analgesia has any negative effects on children's brain development.Furthermore,studies had not find that cesarean section improved children's mental development,nor that instrumental delivery produced children's long-term neurodevelopmental retardation.Trend Current results have not find that neuraxial labor analgesia has adverse impacts on children.Further studies are needed to illuminate this problem.中国科技核心期刊(ISTIC)08739-742,7473