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放松训练方案对早产孕妇妊娠结局的影响:一项对照临床试验。

The effectiveness of a relaxation training program for women with preterm labour on pregnancy outcomes: a controlled clinical trial.

机构信息

Department of Nursing, Chang Gung University of Science and Technology, 261 Wen-Hwa 1st Road, Kwei-shan, Taoyuan 333, Taiwan.

出版信息

Int J Nurs Stud. 2012 Mar;49(3):257-64. doi: 10.1016/j.ijnurstu.2011.09.007. Epub 2011 Oct 2.

Abstract

BACKGROUND

Prenatal maternal stress is associated with adverse birth outcomes. Few studies have been published on the effectiveness of relaxation techniques focusing on women with preterm labour.

OBJECTS

The object of this study was to examine the effectiveness of a relaxation training program on pregnancy outcomes in women experiencing preterm labour.

DESIGN

A single-blinded, controlled clinical trial was used.

SETTINGS

The study was conducted in two hospitals. Both of the study hospitals located in northern Taiwan are also large teaching hospitals and share the same treatment protocols of preterm labour.

PARTICIPANTS

Inclusion criteria were being pregnant and diagnosed with preterm labour, singleton, hospitalized at time of entry into the study, at gestation between 20 and 34 weeks, and having a cervical dilatation of less than 3 cm. Exclusion criteria were if they had one or any combination of the following: antepartum hemorrhage, infection, hypertension, gestational diabetes mellitus, or immunologic disease.

METHODS

The experimental group (n=68) participants received a mini mp3 player containing a 13-min relaxation audio program, which they were instructed to follow daily, while the control group (n=59) received only routine prenatal care. Pregnancy outcomes were obtained from medical charts after each woman gave birth.

RESULTS

Survival analysis demonstrated that the experimental group had a significant pregnancy prolongation compared to the control group (p=0.048). Participants receiving the relaxation training program had a significant lower proportion of extreme preterm birth, a higher rate of not being admitted to a NICU, and a lower rate of stay days within 30 days when compared with the control group. No significant differences were found on pregnancy outcomes in terms of the rate of preterm birth, low birth weight, Apgar score at 1 and 5 min, mode of birth, and perinatal mortality between the two groups.

CONCLUSIONS

Relaxation training for women with preterm labour is effective in delaying of delivery and enhancing positive pregnancy outcomes. This relaxation intervention is cost-effective, noninvasive, and easily applicable in women with preterm labour.

摘要

背景

产前母体应激与不良分娩结局有关。很少有研究发表过关于针对早产妇女的放松技术效果的研究。

目的

本研究旨在探讨放松训练方案对早产妇女妊娠结局的影响。

设计

采用单盲、对照临床试验。

地点

该研究在两家医院进行。这两家医院均位于台湾北部,是大型教学医院,对早产的处理方案相同。

参与者

纳入标准为妊娠且被诊断为早产、单胎、入组时住院、妊娠 20-34 周、宫颈扩张小于 3cm。排除标准为以下任何一种或多种情况:产前出血、感染、高血压、妊娠期糖尿病或免疫性疾病。

方法

实验组(n=68)参与者接受了一个包含 13 分钟放松音频程序的小型 mp3 播放器,他们被指示每天按照程序进行放松,而对照组(n=59)仅接受常规产前护理。每位女性分娩后从病历中获取妊娠结局数据。

结果

生存分析显示,实验组的妊娠延长时间明显长于对照组(p=0.048)。与对照组相比,接受放松训练的参与者中极早产的比例显著降低,未入住新生儿重症监护病房(NICU)的比例更高,30 天内住院天数更少。两组间早产、低出生体重、1 分钟和 5 分钟时的 Apgar 评分、分娩方式和围产儿死亡率等妊娠结局的发生率无显著差异。

结论

针对早产妇女的放松训练可有效延迟分娩并改善妊娠结局。这种放松干预具有成本效益、非侵入性且易于应用于早产妇女。

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