Department of Obstetrics and Gynaecology, Akershus University Hospital, Oslo, Norway.
Department of Fetal Medicine, Oslo University Hospital, Oslo, Norway.
PLoS One. 2017 Oct 18;12(10):e0186564. doi: 10.1371/journal.pone.0186564. eCollection 2017.
To investigate the obstetric and psychological characteristics of women who opt to use epidural analgesia (EDA) during labour and the impact of participating in labour preparation courses on women's decisions to use EDA.
Longitudinal cohort study.
Akershus University Hospital, Norway.
2596 women with singleton pregnancies and intended vaginal delivery.
Data were collected using two self-completed questionnaires at pregnancy weeks 17 and 32. Fear of childbirth was assessed by the Wijma Delivery Expectancy Questionnaire (W-DEQ). Symptoms of anxiety were measured by the Hopkins Symptom Check List (SCL-25) and depression by the Edinburgh Postnatal Depression Scale (EPDS). Obstetric and socio-demographic information was retrieved from birth records at the maternity ward.
Preference for EDA was indicated by the questionnaire item "I would prefer an epidural regardless" on a 4-point scale (1 = highly agree, 4 = highly disagree) at pregnancy week 32.
Twenty-one percent of the women (540/2596) answered that they would choose EDA as the only alternative method of analgesia during labour. Counselling for fear of childbirth [OR 3.23 (95%CI 2.12; 4.92)] and W-DEQ sum score ≥ 85 [OR 2.95 (95%CI 2.06; 4.23)] were significantly (p<0.001) associated with choice of EDA. Participation in labour preparation courses was significantly (p = 0.008) associated with a reduction of intended use of EDA during labour [OR 0.67 (95%CI 0.49; 0.90)].
Fear of childbirth is significantly associated with women's choice of EDA during labour. On the other hand, women that participate in labour preparation courses would rather consider other methods of analgesia during labour.
探讨选择硬膜外分娩镇痛（EDA）的产妇的产科和心理特征，以及参与分娩准备课程对产妇选择 EDA 的影响。
纵向队列研究。
挪威阿克什胡斯大学医院。
2596 名单胎妊娠且计划阴道分娩的孕妇。
在妊娠 17 周和 32 周时使用两份自我完成的问卷收集数据。分娩期望问卷（W-DEQ）评估分娩恐惧。霍普斯金症状清单（SCL-25）测量焦虑症状，爱丁堡产后抑郁量表（EPDS）测量抑郁症状。产科和社会人口学信息从产科病房的分娩记录中检索。
妊娠 32 周时，问卷项目“无论如何我都更愿意使用硬膜外麻醉”（1 = 非常同意，4 = 非常不同意）表示对 EDA 的偏好。
21%的女性（540/2596）表示，她们将选择 EDA 作为分娩时唯一的镇痛方法。对分娩恐惧的咨询[OR 3.23（95%CI 2.12；4.92）]和 W-DEQ 总分≥85[OR 2.95（95%CI 2.06；4.23）]与选择 EDA 显著相关（p<0.001）。参加分娩准备课程与减少分娩时计划使用 EDA 显著相关[OR 0.67（95%CI 0.49；0.90）]（p = 0.008）。
分娩恐惧与产妇选择 EDA 显著相关。另一方面，参加分娩准备课程的女性更愿意在分娩时考虑其他镇痛方法。
