与硬膜外使用相关的危险因素。
Risk factors associated with epidural use.
作者信息
Lancaster Samuel M, Schick Ursula M, Osman Morwan M, Enquobahrie Daniel A
机构信息
Department of Epidemiology, University of Washington, Seattle, Washington, USA.
出版信息
J Clin Med Res. 2012 Apr;4(2):119-26. doi: 10.4021/jocmr810w. Epub 2012 Mar 23.
BACKGROUND
Identify variables associated with intrapartum epidural use.
METHODS
Odds ratios were calculated to quantify associations between selected variables and epidural use using a population-based case-control study of Washington State birth certificate data from 2009.
RESULTS
Non-Whites had 10 - 45% lower odds of epidural use relative to Whites. Foreign-born women had 25 - 45% lower odds of epidural use compared to their US-born counterparts, except for Asians. Women who smoked or induced labor had higher roughly 2-fold higher odds of epidural use compared with non-smokers or women giving birth spontaneously, respectively. Women without a high school diploma or equivalent had lower odds of epidural use relative to those who graduated. Delivering at perinatal units, rural hospitals, or non-profit hospitals had ~50% lower odds of epidural use compared with secondary/teritiary perinatal units, urban hospitals or for-profit hospitals, respectively.
CONCLUSION
Several individual and health service-related variables were associated with epidural use. These findings elucidate the clinical relevance of epidural use, and dispariaties in its utilization and in quality of care during delivery.
KEYWORDS
Epidural use; Foreign birth; Labor; Racial disparities.
背景
确定与产时硬膜外使用相关的变量。
方法
使用基于人群的病例对照研究，对2009年华盛顿州出生证明数据进行分析，计算优势比以量化选定变量与硬膜外使用之间的关联。
结果
与白人相比，非白人硬膜外使用的几率低10%-45%。除亚洲人外，外国出生的女性硬膜外使用几率比美国出生的女性低25%-45%。吸烟或引产的女性硬膜外使用几率分别比不吸烟者或自然分娩的女性高约2倍。没有高中文凭或同等学历的女性硬膜外使用几率低于有高中文凭的女性。在围产期单位、农村医院或非营利性医院分娩的女性硬膜外使用几率分别比在二级/三级围产期单位、城市医院或营利性医院低约50%。
结论
几个与个体和医疗服务相关的变量与硬膜外使用有关。这些发现阐明了硬膜外使用的临床相关性，以及其在使用和分娩护理质量方面的差异。
关键词
硬膜外使用；外国出生；分娩；种族差异。
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