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孕期因害怕分娩而接受个体化治疗的女性的产科结局。

Obstetric outcome for women who received individualized treatment for fear of childbirth during pregnancy.

机构信息

Division of Obstetrics and Gynecology, Department of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, Department of Obstetrics and Gynecology in Linköping, County Council of Östergötland, Linköping, Sweden.

出版信息

Acta Obstet Gynecol Scand. 2012 Jan;91(1):44-49. doi: 10.1111/j.1600-0412.2011.01242.x. Epub 2011 Oct 10.

Abstract

OBJECTIVE

To compare obstetric outcomes for women with fear of childbirth who received counseling during pregnancy with women without fear of childbirth.

DESIGN

Descriptive, retrospective case-control study.

SETTING

University Hospital, Linköping, Sweden.

SAMPLE

353 women who were referred to a unit for psychosocial obstetrics and gynecology because of fear of childbirth constituted the index group and 579 women without fear of childbirth formed a reference group. METHODS. Data were collected from standardized antenatal and delivery records.

MAIN OUTCOME MEASURES

Delivery data.

RESULTS

Elective cesarean sections (CS) were more frequent in the index group (p<0.001). Induction of delivery was also more common among the women with fear of childbirth (16.5 compared with 9.6%, p<0.001). Women with fear of childbirth who were scheduled for vaginal delivery were more often delivered by emergency CS (p=0.007). Elective CS was more common among the parous women with fear of childbirth and instrumental delivery was more common among nulliparous women with fear of childbirth. There were no differences in complications during pregnancy, delivery or postpartum between the two groups.

CONCLUSION

Fear of childbirth is a predisposing factor for emergency and elective CS even after psychological counseling. Maximal effort is necessary to avoid traumatizing deliveries and negative experiences, especially for nulliparous women.

摘要

目的

比较妊娠期间接受分娩恐惧咨询的产妇与无分娩恐惧的产妇的产科结局。

设计

描述性、回顾性病例对照研究。

地点

瑞典林雪平大学医院。

样本

353 名因分娩恐惧而被转介到心理产科和妇科单位的妇女构成了研究组,579 名无分娩恐惧的妇女构成了对照组。

方法

数据来自标准化的产前和分娩记录。

主要观察指标

分娩数据。

结果

研究组剖宫产率更高(p<0.001)。选择性剖宫产(CS)率也更高(16.5%对比 9.6%,p<0.001)。计划阴道分娩的产妇中,行急诊 CS 分娩的比例更高(p=0.007)。恐惧分娩的经产妇中,行选择性 CS 分娩的比例更高,而恐惧分娩的初产妇中,行器械助产的比例更高。两组孕妇在妊娠、分娩和产后并发症方面无差异。

结论

即使在接受心理辅导后,分娩恐惧仍然是急诊和选择性 CS 的一个诱发因素。必须尽最大努力避免创伤性分娩和负面体验,特别是对初产妇。

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