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产妇自述对分娩的恐惧及其与女性分娩体验和分娩方式的关系:一项基于人群的纵向研究。

Self reported fear of childbirth and its association with women's birth experience and mode of delivery: a longitudinal population-based study.

机构信息

School of Health Sciences, University of Borås, S-501 90 Borås, Sweden; Linnaeus University, S-351 95 Växjö, Sweden.

出版信息

Women Birth. 2012 Sep;25(3):114-21. doi: 10.1016/j.wombi.2011.06.001. Epub 2011 Jul 20.

Abstract

OBJECTIVE

To explore fear of childbirth (FOC) during pregnancy and one year after birth and its association to birth experience and mode of delivery.

DESIGN

A longitudinal population-based study.

POPULATION

Pregnant women who were listed for a routine ultrasound at three hospitals in the middle-north part of Sweden.

METHOD

Differences between women who reported FOC and who did not were calculated using risk ratios with a 95% confidence interval. In order to explain which factors were most strongly associated to suffer from FOC during pregnancy and one year after childbirth, multivariate logistic regression analyses were used.

RESULTS

FOC during pregnancy in multiparous women was associated with a previous negative birth experience (RR 5.1, CI 2.5-10.4) and a previous emergency caesarean section (RR 2.5, CI 1.2-5.4). Associated factors for FOC one year after childbirth were: a negative birth experience (RR 10.3, CI 5.1-20.7), fear of childbirth during pregnancy (RR 7.1, CI 4.4-11.7), emergency caesarean section (RR 2.4, CI 1.2-4.5) and primiparity (RR 1.9, CI 1.2-3.1).

CONCLUSION

FOC was associated with negative birth experiences. Women still perceived the birth experience as negative a year after the event. Women's perception of the overall birth experience as negative seems to be more important for explaining subsequent FOC than mode of delivery. Maternity care should focus on women's experiences of childbirth. Staff at antenatal clinics should ask multiparous women about their previous experience of childbirth. So that FOC is minimized, research on factors that create a positive birth experience for women is required.

摘要

目的

探讨孕期和产后一年的分娩恐惧(FOC)及其与分娩经历和分娩方式的关系。

设计

一项基于人群的纵向研究。

人群

在瑞典中北部的 3 家医院进行常规超声检查的孕妇。

方法

使用风险比(95%置信区间)计算报告 FOC 的女性与未报告 FOC 的女性之间的差异。为了解释哪些因素与孕期和产后一年期间最容易出现 FOC 相关,采用多元逻辑回归分析。

结果

多产妇的孕期 FOC 与先前的负面分娩经历(RR 5.1,CI 2.5-10.4)和先前的紧急剖宫产(RR 2.5,CI 1.2-5.4)相关。产后一年 FOC 的相关因素为:负面分娩经历(RR 10.3,CI 5.1-20.7)、孕期 FOC(RR 7.1,CI 4.4-11.7)、紧急剖宫产(RR 2.4,CI 1.2-4.5)和初产妇(RR 1.9,CI 1.2-3.1)。

结论

FOC 与负面分娩经历相关。女性在事件发生一年后仍认为分娩经历是负面的。女性对整体分娩经历的负面看法似乎比分娩方式更能解释随后的 FOC。产妇护理应关注女性的分娩体验。产前检查的工作人员应询问多产妇的既往分娩经历。为了最大限度地减少 FOC,需要研究为女性创造积极分娩体验的因素。

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