Association Between Surgeon Gender and Maternal Morbidity After Cesarean Delivery

医学 子宫的 氨甲环酸 产科 入射(几何) 妇产科学 怀孕 妊娠期 随机对照试验 输血 前瞻性队列研究 产妇死亡 妇科 失血 人口 外科 内科学 物理 催产素 生物 光学 遗传学 环境卫生
作者
Hanane Bouchghoul,Catherine Deneux‐Tharaux,Aurore Georget,Hugo Madar,Antoine Bénard,Loïc Sentilhes,Loïc Sentilhes,Catherine Deneux‐Tharaux,Aurore Goerget,Antoine Bénard,Hugo Madar,Marie-Victoire Sénat,Maëla Le Lous,Norbert Winer,Patrick Rozenberg,Gilles Kayem,É. Verspyck,Florent Fuchs,Élie Azria,Denis Gallot,Diane Kork,Raoul Desbrière,Camille Le Ray,Céline Chauleur,Fanny de Marcillac,Franck Perrotin,Olivier Parant,Laurent Salomon,Émilie Gauchotte,Florence Bretelle,Nicolas Sananès,Caroline Bohec,Nicolas Mottet,Guillaume Legendre,V. Letouzey,Bassam Haddad,Delphine Vardon,Alizée Froeliger,Hanane Bouchghoul,Valérie Daniel,Sophie Regueme,Caroline Roussillon,Astrid Darsonval
出处
期刊:JAMA Surgery [American Medical Association]
卷期号:158 (3): 273-273 被引量:2
标识
DOI:10.1001/jamasurg.2022.7063
摘要

The stereotype that men perform surgery better than women is ancient. Surgeons have long been mainly men, but in recent decades an inversion has begun; the number of women surgeons is increasing, especially in obstetrics and gynecology. Studies outside obstetrics suggest that postoperative morbidity and mortality may be lower after surgery by women.To evaluate the association between surgeons' gender and the risks of maternal morbidity and postpartum hemorrhage (PPH) after cesarean deliveries.This prospective cohort study was based on data from the Tranexamic Acid for Preventing Postpartum Hemorrhage after Cesarean Delivery (TRAAP2) trial, a multicenter, randomized, placebo-controlled trial that took place from March 2018 through January 2020 (23 months). It aimed to investigate whether the administration of tranexamic acid plus a prophylactic uterotonic agent decreased PPH incidence after cesarean delivery compared with a uterotonic agent alone. Women having a cesarean delivery before or during labor at or after 34 weeks' gestation were recruited from 27 French maternity hospitals.Self-reported gender (man or woman), assessed by a questionnaire immediately after delivery.The primary end point was the incidence of a composite maternal morbidity variable, and the secondary end point was the incidence of PPH (the primary outcome of the TRAAP2 trial), defined by a calculated estimated blood loss exceeding 1000 mL or transfusion by day 2.Among 4244 women included, men surgeons performed 943 cesarean deliveries (22.2%) and women surgeons performed 3301 (77.8%). The rate of attending obstetricians was higher among men (441 of 929 [47.5%]) than women (687 of 3239 [21.2%]). The risk of maternal morbidity did not differ for men and women surgeons: 119 of 837 (14.2%) vs 476 of 2928 (16.3%) (adjusted risk ratio, 0.92 [95% CI, 0.77-1.13]). Interaction between surgeon gender and level of experience on the risk of maternal morbidity was not statistically significant. Similarly, the groups did not differ for PPH risk (adjusted risk ratio, 0.98 [95% CI, 0.85-1.13]).Risks of postoperative maternal morbidity and of PPH exceeding 1000 mL or requiring transfusion by day 2 did not differ by the surgeon's gender.
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