Hatamleh Reem, Abujilban Sanaa, AbuAbed Asma'a Shaker AbdelMahdi, Abuhammad Sawsan
Faculty of Nursing, Jordan University of Science and Technology, B.O. Box 3030, Irbid 22110, Jordan.
Faculty of Nursing, Hashemite University, B.O. box 330127. Zarqa 13133, Jordan.
Midwifery. 2019 May;72:23-29. doi: 10.1016/j.midw.2019.02.002. Epub 2019 Feb 7.
This study aimed to examine the effectiveness of a childbirth preparation course on birth outcomes among nulliparous Jordanian women.
A randomized control trial pre-test/post-test design was used to assess the effects of a childbirth preparation course conducted in a military hospital in Amman, Jordan from 1 July to 15 September 2016. A total of 133 low-risk nulliparous women were recruited and randomly assigned to either (1) a control group who received standard care in antenatal clinics or (2) an intervention group who received standard care in antenatal clinics as well as a childbirth preparation course specifically designed for the purpose of this study. Data were collected at two different time points: at recruitment and within 24 to 48 h after giving birth. The chi-square test and independent sample t-test were used to compare birth outcomes.
Low-risk nulliparous women in their third trimester of pregnancy attending antenatal clinics at King Hussein Medical Centre in Amman, the capital of Jordan.
The childbirth preparation course had a positive effect on three birth outcomes. Specifically, more women in the intervention group than in the control group had spontaneous onset of labour (89.0% vs 70.3%, p = .02), the average of cervical dilation was greater in the intervention group than in the control group [(mean = 3.8, SD = 1.55) vs (mean = 3.2, SD = 1.61); t = 2.24, p = .03] and there was earlier initiation of breastfeeding in the intervention group than in the control group [(mean = 6.2, SD = 0.4.43) vs (mean = 17.8, SD = 18.08); t = 4.90, p ≤ 01].
The findings suggest that the childbirth preparation course increased the likelihood of pregnant women having spontaneous onset of labour and arriving at the maternity ward in active labour. Moreover, it helped them to initiate breastfeeding earlier after birth. No effect was found for other birth outcomes or neonatal outcomes. Further studies with a larger sample are needed to obtain more definitive conclusions.
It is recommended that policymakers and administrators facilitate the embedding of this childbirth preparation course into antenatal care to improve maternal and neonatal health.
本研究旨在探讨分娩准备课程对约旦初产妇分娩结局的有效性。
采用随机对照试验前测/后测设计，以评估2016年7月1日至9月15日在约旦安曼一家军事医院开展的分娩准备课程的效果。共招募了133名低风险初产妇，并将她们随机分为两组：（1）对照组，在产前诊所接受标准护理；（2）干预组，在产前诊所接受标准护理，并参加为本研究专门设计的分娩准备课程。在两个不同时间点收集数据：招募时和分娩后24至48小时内。采用卡方检验和独立样本t检验比较分娩结局。
约旦首都安曼侯赛因国王医疗中心产前诊所的妊娠晚期低风险初产妇。
分娩准备课程对三项分娩结局有积极影响。具体而言，干预组自然发动分娩的女性多于对照组（89.0%对70.3%，p = 0.02），干预组宫颈扩张平均值大于对照组[（均值 = 3.8，标准差 = 1.55）对（均值 = 3.2，标准差 = 1.61）；t = 2.24，p = 0.03]，且干预组开始母乳喂养的时间早于对照组[（均值 = 6.2，标准差 = 0.443）对（均值 = 17.8，标准差 = 18.08）；t = 4.90，p≤0.01]。
研究结果表明，分娩准备课程增加了孕妇自然发动分娩并在活跃期到达产房的可能性。此外，它有助于她们在产后更早开始母乳喂养。未发现对其他分娩结局或新生儿结局有影响。需要进行更大样本的进一步研究以获得更明确的结论。
建议政策制定者和管理人员推动将此分娩准备课程纳入产前护理，以改善母婴健康。
