Hetherington S E
Birth. 1990 Jun;17(2):86-90. doi: 10.1111/j.1523-536x.1990.tb00705.x.
After the development and initiation of prepared childbirth classes in a large, inner-city hospital, a case-controlled study was designed to assess their impact on obstetric outcomes. Prepared couples were matched with nonattenders on six variables: race, patient status (clinic or private), parity, marital status, age, and socioeconomic status. Statistically significant differences between the groups were found. Prepared couples were more likely to receive little or no pain medication and less conduction anesthesia than controls. Consequently, 79 percent of their deliveries were spontaneous, compared to 51 percent for controls (P less than 0.001). Despite the increased pushing ability of the class attenders, over 80 percent of women in both groups had an episiotomy, which was, in turn, significantly associated with a second-, third-, or fourth-degree laceration, thus bringing into question its routine use. Further studies to identify additional factors associated with positive obstetric outcomes are warranted.
在一家大型市中心医院开展并启动了准备分娩课程后，设计了一项病例对照研究以评估其对产科结局的影响。将参加准备分娩课程的夫妇与未参加者在六个变量上进行匹配：种族、患者状态（诊所或私人）、胎次、婚姻状况、年龄和社会经济地位。发现两组之间存在统计学上的显著差异。与对照组相比，参加准备分娩课程的夫妇更有可能很少或不使用止痛药物，并且接受传导麻醉的比例更低。因此，他们79%的分娩是自然分娩，而对照组为51%（P小于0.001）。尽管参加课程的产妇用力分娩的能力有所提高，但两组中超过80%的女性都进行了会阴切开术，而这又与二度、三度或四度撕裂伤显著相关，因此对其常规使用提出了质疑。有必要进行进一步的研究以确定与良好产科结局相关的其他因素。
