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根据产次、孕周和产科病史对分娩恐惧的研究。

Fear of childbirth according to parity, gestational age, and obstetric history.

作者信息

Rouhe H, Salmela-Aro K, Halmesmäki E, Saisto T

机构信息

Department of Obstetrics and Gynaecology, Helsinki University Central Hospital, Helsinki, Finland.

出版信息

BJOG. 2009 Jan;116(1):67-73. doi: 10.1111/j.1471-0528.2008.02002.x. Epub 2008 Dec 3.

Abstract

OBJECTIVE

To examine fear of childbirth according to parity, gestational age, and obstetric history.

DESIGN

A questionnaire study.

POPULATION AND SETTING

1400 unselected pregnant women in outpatient maternity clinics of a university central hospital.

METHODS

Visual analogue scale (VAS) and Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ) and preferred mode of delivery.

MAIN OUTCOME MEASURES

W-DEQ and VAS scores according to parity, gestational age, obstetric history, and preferred mode of delivery.

RESULTS

The W-DEQ and VAS scores were higher in nulliparous (W-DEQ 72.0 +/- 20.0 [mean +/- SD] and VAS 4.7 [median]) than parous women (65.4 +/- 21.9; 3.2, P < 0.001 for both W-DEQ and VAS). Higher W-DEQ and VAS scores were found for those beyond 21 weeks of gestation compared with those before (W-DEQ 71.6 +/- 23.0 versus 66.6 +/- 20.0, P < 0.001; VAS 4.7 versus 3.2, P < 0.001). Caesarean section was preferred mode of delivery for 8.1% and these women scored higher on fear (W-DEQ 87.6 +/- 26.5, VAS median 7.0) than those who preferred vaginal delivery (W-DEQ 61.8 +/- 18.7, VAS 2.7, P < 0.001, respectively). Those with a previous caesarean scored higher on fear (W-DEQ 73.2 +/- 23.5, VAS 5.1) than parous women without previous caesarean (W-DEQ 63.3 +/- 20.8, VAS 2.9, P < 0.001, respectively). Those with a history of a vacuum extraction (VE) (W-DEQ 70.6 +/- 19.7, VAS 5.0) had higher fear scores than those without (W-DEQ 64.8 +/- 22.0, P < 0.05 and VAS 3.0, P < 0.001).

CONCLUSION

Severe fear of childbirth was more common in nulliparous women, in later pregnancy, and in women with previous caesarean section or VE. Caesarean section as a preferred mode of childbirth was strongly associated with high score in both W-DEQ and VAS.

摘要

目的

根据产次、孕周和产科病史来研究分娩恐惧。

设计

问卷调查研究。

研究对象与地点

某大学中心医院门诊产科诊所的1400名未经筛选的孕妇。

方法

视觉模拟评分法(VAS)、维伊玛分娩预期/体验问卷(W-DEQ)以及首选分娩方式。

主要观察指标

根据产次、孕周、产科病史和首选分娩方式得出的W-DEQ和VAS评分。

结果

初产妇的W-DEQ和VAS评分(W-DEQ 72.0±20.0[均值±标准差],VAS中位数4.7)高于经产妇(65.4±21.9;3.2,W-DEQ和VAS的P值均<0.001)。与妊娠21周之前的孕妇相比,妊娠21周之后的孕妇W-DEQ和VAS评分更高(W-DEQ 71.6±23.0对66.6±20.0,P<0.001;VAS 4.7对3.2,P<0.001)。8.1%的孕妇首选剖宫产,这些孕妇的恐惧评分更高(W-DEQ 87.6±26.5,VAS中位数7.0),高于首选阴道分娩的孕妇(W-DEQ 61.8±18.7,VAS 2.7,P值分别<0.001)。有剖宫产史的孕妇恐惧评分更高(W-DEQ 73.2±23.5,VAS 5.1),高于无剖宫产史的经产妇(W-DEQ 63.3±20.8,VAS 2.9,P值分别<0.001)。有真空吸引助产史(VE)的孕妇(W-DEQ 70.6±19.7,VAS 5.0)恐惧评分高于无该病史的孕妇(W-DEQ 64.8±22.0,P<0.05;VAS 3.0,P<0.001)。

结论

严重的分娩恐惧在初产妇、妊娠晚期以及有剖宫产史或真空吸引助产史的孕妇中更为常见。剖宫产作为首选分娩方式与W-DEQ和VAS的高分密切相关。

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