Department of Obstetrics and Gynecology, GROW School for Oncology and Developmental Biology, Maastricht University Medical Center+, PO Box 5800, 6202, Maastricht, AZ, The Netherlands.
Department of Rehabilitation Research & Clinical Psychological Sciences, Maastricht University, PO Box 616, 6200, Maastricht, MD, The Netherlands.
Qual Life Res. 2018 Aug;27(8):2027-2033. doi: 10.1007/s11136-018-1838-z. Epub 2018 Mar 30.
The purpose of this study was to evaluate the changes in maternal quality of life (QOL) from pregnancy to 6 weeks after delivery between routine labor epidural analgesia (EA) and pain relief on maternal request only.
\Women delivering of a singleton in cephalic presentation beyond 36 + 0 weeks' gestation were randomly allocated to EA as a routine during labor (routine EA group), or to any kind of analgesia on request only (control group). The Short Form health survey (SF-36) was used to assess women's QOL before randomization, and 6 weeks postpartum. Data were analyzed according to the intention to treat principle.
A total of 488 women were included, and antepartum as well as postpartum SF-36 questionnaires were filled in by 356 (73.0%) women, 176 (49.4%) in the routine EA group, and 180 (50.6%) in the control group. Changes from the QOL antepartum to the QOL 6 weeks postpartum were comparable between both groups, also in the subgroup of women in the control group who gave birth without any pain medication (n = 41, 22.8%). Maternal age and the incidence of adverse events related to EA, which were both higher in the routine EA group, had no influence on the changes in QOL. Differences in request for pain relief were comparable with other studies.
Routine administration of EA during labor and pain relief on maternal request only are associated with comparable changes of women's QOL antepartum to 6 weeks postpartum.
本研究旨在评估常规分娩硬膜外镇痛(EA)与仅按需止痛对产妇生活质量(QOL)的影响。
将孕 36+0 周以上头位分娩的单胎孕妇随机分为分娩时常规 EA(常规 EA 组)或仅按需止痛(对照组)。采用简明健康调查问卷(SF-36)评估孕妇随机分组前及产后 6 周的 QOL。数据按意向治疗原则进行分析。
共纳入 488 例孕妇,356 例(73.0%)孕妇填写了产前及产后 SF-36 问卷,常规 EA 组 176 例(49.4%),对照组 180 例(50.6%)。两组产后 6 周 QOL 变化与产前 QOL 相比无差异,对照组中未使用任何止痛药物分娩的 41 例(22.8%)产妇亚组也无差异。常规 EA 组产妇年龄较大,与 EA 相关的不良事件发生率较高,但对 QOL 变化无影响。两组对止痛的需求差异与其他研究相当。
分娩时常规 EA 与仅按需止痛对产妇 QOL 的影响相似,均可使产妇产前至产后 6 周的 QOL 发生变化。