Department of Obstetrics and Gynecology, Helsinki University Central Hospital, Helsinki, Finland; University of Helsinki, Helsinki, Finland.
Acta Obstet Gynecol Scand. 2014 Sep;93(9):880-7. doi: 10.1111/aogs.12440. Epub 2014 Jul 2.
To determine how infertility and subsequent assisted reproductive treatment (ART) affect a woman's childbirth experience.
Prospective multicenter case-control study.
We recruited women pregnant with a singleton fetus after either ART (n = 324) or spontaneous conception (n = 304) from five infertility clinics and one university maternity clinic in Finland.
We studied their childbirth experience with the Delivery Satisfaction Scale. We compared how psychosocial and obstetric factors affected satisfaction and dissatisfaction with childbirth between and within the ART and the control group. Logistic regression was then used to analyse the most important contributors to the experienced dissatisfaction.
Dissatisfaction with childbirth was as common in the ART group (11%) as in the control (10%) group. In the ART group, the women's education level, cesarean section (CS) and their partner's absence from the delivery were associated with dissatisfaction. In the control group, significant factors for dissatisfaction were nulliparity, severe pregnancy-related anxiety, emergency CS, recalled intense pain and the partner's absence from the delivery. According to adjusted logistic regression analysis of the whole sample, the independent risk factors were elective CS [odds ratio (OR) 5.7; 95% confidence interval (CI) 2.2-14.1] and emergency CS (OR 2.9; 95% CI 1.3-6.5), recalled intense pain (OR 6.8; 95% CI 3.3-16.2) and the partner's absence from the delivery (OR 2.7; 95% CI 1.1-7.3).
ART is not a risk factor for dissatisfaction with childbirth by itself. However, the contributors to an unsatisfactory childbirth differ partly between women conceiving with ART and those conceiving spontaneously.
探讨不孕及随后的辅助生殖治疗（ART）如何影响女性的分娩体验。
前瞻性多中心病例对照研究。
我们从芬兰的五家不孕诊所和一家大学妇产诊所招募了接受 ART（n=324）或自然受孕（n=304）后单胎妊娠的女性。
采用分娩满意度量表研究其分娩体验。我们比较了 ART 组和对照组之间及组内的社会心理和产科因素如何影响分娩的满意度和不满度。然后，我们采用逻辑回归分析来分析导致不满的最重要因素。
ART 组（11%）和对照组（10%）的分娩不满发生率相当。在 ART 组，产妇的教育程度、剖宫产（CS）和其伴侣未陪产与不满相关。在对照组，不满的显著因素为初产妇、严重的妊娠相关焦虑、紧急 CS、回忆起强烈疼痛和伴侣未陪产。根据对整个样本的调整后逻辑回归分析，独立的危险因素为选择性 CS[比值比（OR）5.7；95%置信区间（CI）2.2-14.1]和紧急 CS（OR 2.9；95% CI 1.3-6.5）、回忆起强烈疼痛（OR 6.8；95% CI 3.3-16.2）和伴侣未陪产（OR 2.7；95% CI 1.1-7.3）。
ART 本身并不是导致分娩不满的危险因素。然而，导致不满意分娩的因素在部分上因接受 ART 受孕的女性和自然受孕的女性而不同。
