Peacock Phil J, Zengeya Stanley T, Cochrane Lesley, Sleath Maxine
Emergency Department, Bristol Royal Hospital for Children.
Department of Paediatrics, Great Western Hospital, Swindon.
Cureus. 2018 Feb 20;10(2):e2208. doi: 10.7759/cureus.2208.
Introduction Giving birth in water has increased in popularity over recent years, with potential benefits in terms of maternal comfort and decreased rates of instrumental delivery. Some concerns have been raised about possible adverse neonatal outcomes, including hypothermia and respiratory distress. There is not currently, however, a clear consensus in the literature. This study sought to assess the safety of delivering in water for low-risk vaginal deliveries in a District General Hospital in the United Kingdom. Methods Prospectively collected hospital data was obtained for all deliveries between 1 April 2014 and 31 March 2016 at the Great Western Hospital, Swindon. The dataset was limited to full-term babies born by unassisted vaginal delivery following spontaneous labour; 3507 babies were included in the analyses. Pre-specified outcomes included neonatal unit admission, Apgar scores, and temperature after delivery. Results During the two-year period studied, there were 592 waterbirths and 2915 non-waterbirths. There was no significant difference in rates of neonatal unit admission between waterbirths and non-waterbirths. One-minute Apgar scores were slightly higher among those born in water (P = 0.04); this difference attenuated by five minutes of age. There was no difference in temperature after delivery between the two groups. Conclusions An evaluation of safety in a District General Hospital has demonstrated similar postnatal outcomes among babies born in water, compared to those born on land. Further work examining longer-term outcomes would help assess whether this persists beyond the newborn period.
引言 近年来，水中分娩越来越受欢迎，在产妇舒适度和降低器械助产率方面具有潜在益处。有人对可能出现的不良新生儿结局提出了一些担忧，包括体温过低和呼吸窘迫。然而，目前文献中尚无明确的共识。本研究旨在评估英国一家地区综合医院中低风险阴道分娩进行水中分娩的安全性。
方法 前瞻性收集了2014年4月1日至2016年3月31日期间在斯温顿的大西部医院所有分娩的医院数据。数据集仅限于自然分娩后经阴道顺产的足月儿；3507名婴儿纳入分析。预先设定的结局包括新生儿病房入住情况、阿氏评分和出生后体温。
结果 在研究的两年期间，有592例水中分娩和2915例非水中分娩。水中分娩和非水中分娩的新生儿病房入住率无显著差异。水中出生的婴儿1分钟阿氏评分略高（P = 0.04）；这种差异在出生5分钟时减弱。两组出生后体温无差异。
结论 在一家地区综合医院进行的安全性评估表明，与陆地出生的婴儿相比，水中出生的婴儿产后结局相似。进一步研究长期结局将有助于评估这种情况在新生儿期之后是否持续存在。
