J Midwifery Womens Health. 2010 Mar-Apr;55(2):101-6. doi: 10.1016/j.jmwh.2009.07.003.
The purpose of this study was to examine factors associated with normal versus non-normal birth outcomes for low-risk women who were admitted for care in spontaneous labor.
The birth records of 93 women were reviewed.
At the completion of the fourth stage of labor, 61% of births (n = 57) met the criteria for normal, while 39% of births (n = 36) had non-normal outcomes. On bivariate analysis, variables associated with non-normal outcomes included nulliparity (odds ratio [OR], 9.10; 95% confidence interval [CI], 3-28; P < .0001), lower average centimeters of dilation at admission (t-score 4.422; P < .001), use of pharmacologic pain relief, including narcotics and epidural anesthesia (OR, 5.03; 95% CI, 2-16; P = .005), and birth attended by a physician versus a certified nurse-midwife (OR, 3.60; 95% CI, 2-9; P = .004). In a multivariate analysis, nulliparity (OR, 6.07; 95% CI, 2-19; P = .002) and lower average centimeters of dilation at admission (OR, 0.63; 95% CI, 0.5-0.9; P = .005) were independently associated with non-normal outcome.
The development of clinical guidelines aimed at reducing admissions of women in early labor may reduce non-normal outcomes, particularly for nulliparous women.
本研究的目的是探讨低危产妇在自然分娩中接受护理时，正常分娩结果与非正常分娩结果相关的因素。
回顾了 93 名产妇的分娩记录。
在第四产程结束时，61%（n=57）的分娩符合正常标准，而 39%（n=36）的分娩结果异常。在单变量分析中，与非正常分娩结果相关的变量包括初产妇（比值比[OR]，9.10；95%置信区间[CI]，3-28；P<.0001）、入院时平均扩张厘米数较低（t 分数 4.422；P<.001）、使用包括麻醉性镇痛药和硬膜外麻醉在内的药物缓解疼痛（OR，5.03；95%CI，2-16；P=.005）以及由医生而不是认证的助产士接生（OR，3.60；95%CI，2-9；P=.004）。在多变量分析中，初产妇（OR，6.07；95%CI，2-19；P=.002）和入院时平均扩张厘米数较低（OR，0.63；95%CI，0.5-0.9；P=.005）与非正常分娩结果独立相关。
制定旨在减少早期分娩妇女入院人数的临床指南，可能会降低非正常分娩结果的发生率，尤其是对初产妇而言。
