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丹麦国家出生队列中初产妇的分娩恐惧与分娩并发症风险

Fear of childbirth and risk for birth complications in nulliparous women in the Danish National Birth Cohort.

作者信息

Laursen M, Johansen C, Hedegaard M

机构信息

Department of Obstetrics, Rigshospitalet, University Hospital of Copenhagen, Copenhagen Ø, Denmark.

出版信息

BJOG. 2009 Sep;116(10):1350-5. doi: 10.1111/j.1471-0528.2009.02250.x. Epub 2009 Jun 17.

Abstract

OBJECTIVES

To examine the associations between fear of childbirth and emergency caesarean section and between fear of childbirth and dystocia or protracted labour and fetal distress.

DESIGN

Prospective cohort study.

SETTING

Danish National Birth Cohort.

POPULATION

A total of 25 297 healthy nulliparous women in spontaneous labour with a single fetus in cephalic presentation at term following an uncomplicated pregnancy.

METHODS

Data were collected during 1997-2003 from computer-assisted telephone interviews twice in pregnancy linked with national health registers.

MAIN OUTCOME MEASURES

Risk for emergency caesarean section of women who feared childbirth; risk for dystocia/protracted labour or fetal distress of women who feared childbirth.

RESULTS

Fear of childbirth in early (16 weeks, 6 +/- 29 days) and late (31 weeks, 4 +/- 21 days) pregnancy was associated with emergency caesarean section: OR, 1.23 (1.05-1.47) and 1.32 (1.13-1.55), respectively. When fear of childbirth was expressed at both interviews, the OR was 1.43 (1.13-1.80). Women who feared childbirth had an increased risk for dystocia or protracted labour (OR, 1.33; 1.15-1.54), but not for fetal distress (OR, 0.94; 0.72-1.23).

CONCLUSIONS

Fear of childbirth during pregnancy was associated with dystocia and emergency caesarean section but not with fetal distress.

摘要

目的

研究分娩恐惧与急诊剖宫产之间的关联,以及分娩恐惧与难产或产程延长及胎儿窘迫之间的关联。

设计

前瞻性队列研究。

地点

丹麦国家出生队列。

研究对象

共有25297名健康初产妇,单胎头位足月自然临产,孕期无并发症。

方法

1997年至2003年期间,通过电脑辅助电话访谈在孕期进行两次数据收集,并与国家健康登记处相链接。

主要观察指标

害怕分娩的女性进行急诊剖宫产的风险;害怕分娩的女性出现难产/产程延长或胎儿窘迫的风险。

结果

孕早期(16周,6±29天)和孕晚期(31周,4±21天)的分娩恐惧与急诊剖宫产相关:比值比分别为1.23(1.05 - 1.47)和1.32(1.13 - 1.55)。若两次访谈均表达了分娩恐惧,则比值比为1.43(1.13 - 1.80)。害怕分娩的女性发生难产或产程延长的风险增加(比值比为1.33;1.15 - 1.54),但胎儿窘迫风险未增加(比值比为0.94;0.72 - 1.23)。

结论

孕期的分娩恐惧与难产和急诊剖宫产相关,但与胎儿窘迫无关。

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