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分娩教育课程的研究及其效果评估。

Study of childbirth education classes and evaluation of their effectiveness.

作者信息

Ricchi A, La Corte S, Molinazzi M T, Messina M P, Banchelli F, Neri I

机构信息

School of Midwifery Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, Italy.

Master "Health Community Care: l'Ostetrica di Comunità" University of Modena and Reggio Emilia, Italy.

出版信息

Clin Ter. 2020 Jan-Feb;170(1):e78-e86. doi: 10.7417/CT.2020.2193.

Abstract

BACKGROUND

Childbirth education classes are antenatal support services offered to pregnant women or to the couple, aimed at increasing their knowledge regarding pregnancy, labour, delivery, breastfeeding, parenthood and newborn care.

OBJECTIVE

The aim was to evaluate the effectiveness of Birthing Classes through the analysis of the occurrence of C-section, epidural analgesia, behavior during labor and delivery of the women who participated to the course as compared to those who did not attend it. Moreover, the level of satisfaction of pregnant women who attended the course was measured with a questionnaire of 20 items handed out after the delivery.

METHODS

To measure the satisfaction level of pregnant women, in the period from February 2017 to October 2017, a questionnaire of 20 items was used. In order to analyze the results of the births the medical records were consulted.

RESULTS

In the period of time going from February 2017 to October 2017 there were 147 women who have delivered and who have filled in the questionnaire. According to the multivariable analysis, there were no differences in the frequency of C-sections between the two groups (OR=0.8, 95%CI=0.3-1.7, p=0.503), whereas the frequency of epidural analgesia was lower in women who attended the Birthing Class (OR=0.3, 95%CI=0.1-0.9, p=0.036). We also observed that women who attended the Birthing Class: 1) had a higher likelihood of using breathing techniques during the labor (OR=5.5, 95%CI=1.5-20.0, p=0.009); 2) had a higher likelihood of taking advantage of the visualization exercises during the labor (OR=2.5, 95%CI=1.1-6.0, p=0.039). There was no other relevant difference between the two groups.

DISCUSSION

The benefits of perinatal education are difficult to evaluate systematically, and further research would be required to determine real effects and agree upon reliable indicators of effectiveness.

CONCLUSIONS

This study identified several positive factors that confirm the results of other studies indicating that antenatal classes are effective for women giving birth for the first time/nulliparous women, based on an analysis of childbirth outcomes, in order to improve maternal and neonatal health.

摘要

背景

分娩教育课程是为孕妇或夫妇提供的产前支持服务,旨在增加他们关于怀孕、分娩、生产、母乳喂养、为人父母及新生儿护理的知识。

目的

目的是通过分析参与该课程的女性与未参加该课程的女性相比,剖宫产、硬膜外镇痛的发生率,以及分娩期间的行为,来评估分娩课程的效果。此外,在分娩后通过发放一份包含20个条目的问卷来测量参加该课程的孕妇的满意度。

方法

为了测量孕妇的满意度,在2017年2月至2017年10月期间,使用了一份包含20个条目的问卷。为了分析分娩结果,查阅了医疗记录。

结果

在2017年2月至2017年10月期间,有147名已分娩且填写了问卷的女性。根据多变量分析,两组之间剖宫产的频率没有差异(比值比=0.8,95%置信区间=0.3 - 1.7,p = 0.503),而参加分娩课程的女性硬膜外镇痛的频率较低(比值比=0.3,95%置信区间=0.1 - 0.9,p = 0.036)。我们还观察到参加分娩课程的女性:1)在分娩期间使用呼吸技巧的可能性更高(比值比=5.5,95%置信区间=1.5 - 20.0,p = 0.009);2)在分娩期间利用想象练习的可能性更高(比值比=2.5,95%置信区间=1.1 - 6.0,p = 0.039)。两组之间没有其他相关差异。

讨论

围产期教育的益处难以系统评估,需要进一步研究以确定实际效果并就可靠的有效性指标达成共识。

结论

本研究确定了几个积极因素,基于对分娩结果的分析,证实了其他研究的结果,表明产前课程对首次分娩的女性/未生育女性有效,以改善母婴健康。

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