Pôle de Gynécologie-Obstétrique, Université de Lorraine, CHRU-Nancy, Nancy, France.
Université de Lorraine, Inserm, IADI, Nancy, France.
BJOG. 2022 Jul;129(8):1333-1341. doi: 10.1111/1471-0528.17082. Epub 2022 Mar 6.
To compare in the early postpartum the perinatal experience during a COVID-19 related lockdown ('lockdown' group) and a pandemic control group subject to looser restrictions.
This national multicentre prospective cohort study took place in four French maternity units.
Women were recruited during the postpartum stay for the lockdown and pandemic control groups, according to their enrolment period. Both faced the same labour and delivery restrictions but only the pandemic control group could have a postpartum visitor.
The primary outcome was the perinatal experience during childbirth, assessed by the Labour Agentry Scale (LAS) self-administered questionnaire, completed before discharge.
The study included 596 women and analysed 571 of them: 260 in the lockdown group and 311 in the pandemic control group. The mean LAS score was lower in the lockdown group (161.1 ± 26.8, 95% confidence interval [CI] 157.8-164.3 versus 163.3 ± 24.0, 95% CI 160.6-166.0; P = 0.289). In multivariable analysis, the LAS score was lower in the lockdown group (-6.2 points, P = 0.009), in women with caesarean (-21.6 points, P < 0.001) versus spontaneous deliveries, and among women financially impacted by the lockdown (-6.4 points, P = 0.007) or who experienced restrictions during childbirth (-8.1 points, P < 0.001). The LAS score rose with the prenatal care quality score (P < 0.001).
The perinatal experience was more negatively affected by lockdown restrictions than by the looser pandemic restrictions for controls, but mode of delivery remained the main factor influencing this experience.
比较新冠疫情封锁期间(“封锁”组)和放宽限制的大流行控制组在产后早期的围产期经历。
这是一项在法国四家产科单位进行的全国多中心前瞻性队列研究。
根据入组时间,在封锁组和大流行对照组的产后期间招募产妇。两组均面临相同的分娩和分娩限制,但只有大流行对照组可以有产后访客。
主要结局是通过分娩时自我管理的劳动代理量表(LAS)问卷评估的围产期经历,在出院前完成。
研究共纳入 596 名女性,分析了其中 571 名:260 名在封锁组,311 名在大流行对照组。封锁组的 LAS 评分较低(161.1±26.8,95%置信区间 [CI] 157.8-164.3 与 163.3±24.0,95%CI 160.6-166.0;P=0.289)。在多变量分析中,封锁组的 LAS 评分较低(-6.2 分,P=0.009),剖宫产(-21.6 分,P<0.001)与自然分娩相比,以及受封锁影响的财务状况的女性(-6.4 分,P=0.007)或在分娩期间经历限制的女性(-8.1 分,P<0.001)。LAS 评分随产前护理质量评分升高(P<0.001)。
与对照组的宽松大流行限制相比,封锁限制对围产期经历的负面影响更大,但分娩方式仍然是影响这种经历的主要因素。