Department of Preventive Medicine, Korea University College of Medicine, Seoul, Republic of Korea; Department of Epidemiology and Health Informatics, Graduate School of Public Health, Korea University, Seoul, Republic of Korea.
Department of Epidemiology and Health Informatics, Graduate School of Public Health, Korea University, Seoul, Republic of Korea; Department of Public Health, Korea University Graduate School, Seoul, Republic of Korea.
Women Birth. 2021 May;34(3):219-230. doi: 10.1016/j.wombi.2020.04.002. Epub 2020 Apr 28.
Many studies on the relation between maternal health and infant health, including the effect of structured antenatal education, have been published and expanded over the years.
Investigate the impact of various antenatal education programmes on pregnancy outcomes to aid the development of future guidelines related to maternal and foetal health.
Bibliographic databases (Cochrane, PubMed, EMBASE, CINAHL, Korean Studies Information Service System) were searched up to November 2018, following the PICO criteria: population (pregnant women), intervention (antenatal education), comparison (not specified), and outcome (maternal and foetal outcome including physical or mental health components).
We included 23 eligible studies consisting of 14 controlled trials and 9 observational studies. The maternal physical outcomes depending on participation in antenatal education were not significantly different; however, the caesarean birth rate was lower in the antenatal education group (relative risk, RR, 0.90; 95% confidence interval, CI, 0.82-0.99), as was the use of epidural anaesthesia (RR, 0.84; 95% CI, 0.74-0.96). The maternal mental health outcomes of stress and self-efficacy significantly improved in the antenatal education group, although there was no difference in anxiety and depression. The foetal outcomes of birth weight or gestational age at birth were also not different between the groups.
Antenatal education can reduce maternal stress, improve self-efficacy, lower the caesarean birth rate, and decrease the use of epidural anaesthesia; however, there is limited evidence of its effects on maternal or foetal physical outcomes. Therefore, antenatal education should be standardised to elucidate its actual mental and physical health effects.
多年来，许多关于母婴健康关系的研究，包括结构化产前教育的效果，已经发表并不断扩展。
调查各种产前教育计划对妊娠结局的影响，以帮助制定未来与母婴健康相关的指南。
根据 PICO 标准（人群[孕妇]、干预[产前教育]、比较[未指定]和结局[母婴结局，包括身体或心理健康成分]），检索了 Cochrane、PubMed、EMBASE、CINAHL 和韩国研究信息服务系统等文献数据库，检索截至 2018 年 11 月。
我们纳入了 23 项符合条件的研究，包括 14 项对照试验和 9 项观察性研究。参加产前教育的产妇身体结局没有显著差异，但产前教育组的剖宫产率较低（相对风险，RR，0.90；95%置信区间，CI，0.82-0.99），硬膜外麻醉的使用率也较低（RR，0.84；95%CI，0.74-0.96）。产前教育组的产妇心理健康结局，如压力和自我效能感显著改善，而焦虑和抑郁没有差异。两组的胎儿结局，如出生体重或出生时的胎龄也没有差异。
产前教育可以减轻产妇的压力，提高自我效能感，降低剖宫产率，减少硬膜外麻醉的使用；然而，其对产妇或胎儿身体结局的影响证据有限。因此，应该规范产前教育，以阐明其实际的身心健康效果。
