Gottvall Karin, Waldenström Ulla
Department of Nursing, Karolinska Institutet, Stockholm, Sweden.
Birth. 2002 Sep;29(3):177-81. doi: 10.1046/j.1523-536x.2002.00185.x.
Women's experiences of childbirth may affect their future reproduction, and the model of care affects their experiences, suggesting that a causal link may exist between model of care and future reproduction. The study objective was to examine whether the birth center model of care during a woman's first pregnancy affects whether or not she has a second baby, and on the spacing to the next birth.
Between October 1989 and July 1993, a total of 1860 women at low medical risk in early pregnancy, who participated in a randomized controlled trial of in-hospital birth center care versus standard care, gave birth. The 1063 primiparas in the trial, 543 in the birth center group and 520 in the standard care group, were included in a secondary analysis in which women's personal identification codes were linked to the Swedish National Birth Register, which included information about their subsequent birth during the following 7 to 10 years. Time to an event curves were constructed by means of the Kaplan Meier method.
The observation period after the first birth was on average 8.8 years in the birth center group and 8.7 years in the standard care group. No statistical difference was found between the groups in time to second birth, which was 2.85 and 2.82 years, respectively (median; log-rank 1.26; p=0.26).
A woman's model of care, such as birth center care, during her first pregnancy does not seem to be a sufficiently important factor to affect subsequent reproduction in Sweden.
女性的分娩经历可能会影响其未来的生育情况,而护理模式会影响她们的分娩体验,这表明护理模式与未来生育之间可能存在因果联系。本研究的目的是探讨女性首次怀孕时的分娩中心护理模式是否会影响其是否生育二胎,以及二胎与下一胎的生育间隔。
1989年10月至1993年7月期间,共有1860名妊娠早期医疗风险较低的女性参与了一项关于住院分娩中心护理与标准护理的随机对照试验并分娩。该试验中的1063名初产妇,其中分娩中心组543名,标准护理组520名,被纳入一项二次分析,这些女性的个人识别码与瑞典国家出生登记册相关联,该登记册包含了她们在接下来7至10年中后续分娩的信息。采用Kaplan-Meier方法构建事件发生时间曲线。
分娩中心组首次分娩后的观察期平均为8.8年,标准护理组为8.7年。两组之间在生育二胎的时间上没有统计学差异,分别为2.85年和2.82年(中位数;对数秩检验χ² = 1.26;p = 0.26)。
在瑞典,女性首次怀孕时的护理模式,如分娩中心护理,似乎并不是影响其后续生育的一个足够重要的因素。