Gagnon A J
School of Nursing, McGill University, 3506 University Street, Montreal, Quebec, Canada, H3A 2A7.
Cochrane Database Syst Rev. 2000(4):CD002869. doi: 10.1002/14651858.CD002869.
Structured antenatal education programs for childbirth and/or parenthood are commonly recommended for pregnant women and their partners by health care professionals in many parts of the world. Such programs are usually offered to groups but may be offered to individuals.
The objective of this review was to assess the effects of this education on knowledge acquisition, anxiety, sense of control, pain, support, breastfeeding, infant care abilities, and psychological and social adjustment.
The Cochrane Pregnancy and Childbirth Group trials register, the Cochrane Controlled Trials Register, and other databases were searched. The date of the last search was December, 1999.
Randomized controlled trials of any structured educational program provided during pregnancy by an educator to either parent, that included information related to pregnancy, birth, or parenthood were included. The educational interventions could have been provided on an individual or group basis. Educational interventions directed exclusively to either increasing breastfeeding success or reducing smoking were excluded, since reviews of these topics can be found elsewhere in The Cochrane Library.
Trial quality was assessed and data were extracted by the author from published reports.
Six trials, involving 1443 women, were included. Twenty-two were excluded. The largest of the included studies (n = 1275) examined an educational intervention to increase vaginal birth after cesarean section. This high quality study showed similar rates of vaginal birth after cesarean section in 'verbal' and 'document' groups, relative risk (RR) 1.1 (95% confidence interval (CI) 1.0-1.2). More general educational interventions were the focus of the other five studies (combined n = 168). The methodological quality of these trials is uncertain, since details of the randomization procedure, allocation concealment, and/or participant accrual/loss were not reported. No consistent results were found. Sample sizes were very small, ranging from 10-67. Interventions, populations, and outcomes measured were different in each study. No data from the five general education trials were reported concerning labour and birth outcomes, anxiety, breastfeeding success, or general social support. Knowledge acquisition and factors related to infant care competencies were measured.
REVIEWER'S CONCLUSIONS: Individualized prenatal education directed toward avoidance of a cesarean birth does not increase the rate of vaginal birth after cesarean section. The effects of general antenatal education for childbirth and/or parenthood remain unknown.
在世界许多地区，医疗保健专业人员通常向孕妇及其伴侣推荐有关分娩和/或为人父母的结构化产前教育项目。此类项目通常以小组形式提供，但也可能提供给个人。
本综述的目的是评估这种教育对知识获取、焦虑、控制感、疼痛、支持、母乳喂养、婴儿护理能力以及心理和社会适应的影响。
检索了Cochrane妊娠与分娩小组试验注册库、Cochrane对照试验注册库及其他数据库。最后一次检索日期为1999年12月。
纳入由教育者在孕期向父母任何一方提供的任何结构化教育项目的随机对照试验，该项目包括与妊娠、分娩或为人父母相关的信息。教育干预可以以个体或小组形式提供。专门针对提高母乳喂养成功率或减少吸烟的教育干预被排除，因为这些主题的综述可在《Cochrane图书馆》的其他地方找到。
评估试验质量，作者从已发表的报告中提取数据。
纳入六项试验，涉及1443名妇女。排除22项试验。纳入的最大规模研究（n = 1275）考察了一项旨在增加剖宫产术后阴道分娩率的教育干预措施。这项高质量研究表明，“口头”组和“文档”组的剖宫产术后阴道分娩率相似，相对危险度（RR）为1.1（95%置信区间（CI）1.0 - 1.2）。其他五项研究（合并n = 168）关注的是更一般性的教育干预措施。这些试验的方法学质量不确定，因为未报告随机化程序、分配隐藏和/或参与者纳入/失访的细节。未发现一致的结果。样本量非常小，范围从10至67。每项研究中的干预措施、研究对象和测量的结局均不同。五项一般性教育试验均未报告有关分娩结局、焦虑、母乳喂养成功率或一般社会支持的数据。测量了知识获取以及与婴儿护理能力相关的因素。
旨在避免剖宫产的个体化产前教育不会提高剖宫产术后阴道分娩率。一般性产前教育对分娩和/或为人父母的影响仍不明确。
