剖宫产后再次妊娠孕妇分娩恐惧及其预测因素的横断面多中心研究。
Fear of childbirth and its predictors in re-pregnant women after cesarean section: a cross-sectional multicenter study in China.
机构信息
Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital and Xiangya School of Nursing, Central South University, Changsha, Hunan, China.
Clinical Nursing Teaching and Research Section and Department of Obstetrics, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China.
出版信息
BMC Pregnancy Childbirth. 2022 May 7;22(1):393. doi: 10.1186/s12884-022-04721-z.
BACKGROUND
Since the implementation of China's two-child policy in 2016, the number of re-pregnant women after cesarean section has increased significantly. These women are more prone to fear of childbirth compared with primiparas due to their history of scarred uterus leading to a more complicated delivery process, which poses a great threat to their physical and mental health. However, there is currently limited research on the problem in China. The aim of this study was to assess fear of childbirth and its predictors in re-pregnant women after cesarean section in China.
METHODS
A cross-sectional multicenter study was conducted in three hospitals from June 7 to December 7, 2020, in Changsha, China. Study hospitals were selected using a random sampling technique. Participants were selected using a convenience sampling technique. Three hundred fifty-eight women during the third trimester of pregnancy who were older than 18 years, having a history of CS(s), and not having major physical or mental health problems were included. Fear of childbirth and its predictors were evaluated using the Childbirth Attitude Questionnaire, the short form of the 32-item Chinese Childbirth Self-Efficacy Inventory, the Social Support Rating Scale, and the demographic-obstetric data sheet. After checking for completeness, data were exported to statistical software for analysis. Both univariate analysis and multiple linear regression analysis were computed to assess fear of childbirth and its predictors. Statistical significance was declared at a P-value of < 0.05.
RESULTS
The average score of fear of childbirth was 43.76 (standard deviation = 5.27, range 17-58). Number of cesarean sections, experience with previous cesarean section, childbirth self-efficacy and social support were significantly associated with fear of childbirth (P < 0.05).
CONCLUSIONS
In this study, re-pregnant women after cesarean section in China had moderate fear of childbirth, and the number of cesarean sections, experience with previous cesarean section, childbirth self-efficacy and social support were predictors of fear of childbirth. It is important for healthcare professionals to find re-pregnant women after cesarean section at high risk of fear of childbirth and provide appropriate services during pregnancy.
背景
自 2016 年中国实施二孩政策以来，剖宫产后再次妊娠的人数明显增加。与初产妇相比，这些妇女由于子宫有疤痕，分娩过程更为复杂，因此更容易对分娩产生恐惧，这对她们的身心健康构成了极大的威胁。然而，目前中国对此问题的研究还很有限。本研究旨在评估中国剖宫产后再次妊娠妇女的分娩恐惧及其预测因素。
方法
本研究为 2020 年 6 月 7 日至 12 月 7 日在中国长沙的三家医院进行的一项横断面多中心研究。采用随机抽样技术选择研究医院。采用便利抽样技术选择参与者。纳入 358 名年龄大于 18 岁、有剖宫产史且无重大躯体或精神健康问题的妊娠晚期妇女。采用分娩态度问卷、中文版 32 项分娩自我效能量表简表、社会支持评定量表和人口学-产科数据表评估分娩恐惧及其预测因素。数据导出到统计软件进行分析。采用单因素分析和多元线性回归分析评估分娩恐惧及其预测因素。P 值<0.05 为差异有统计学意义。
结果
分娩恐惧平均得分为 43.76（标准差=5.27，范围 17-58）。剖宫产次数、既往剖宫产经历、分娩自我效能和社会支持与分娩恐惧显著相关（P<0.05）。
结论
本研究中，中国剖宫产后再次妊娠的妇女存在中等程度的分娩恐惧，剖宫产次数、既往剖宫产经历、分娩自我效能和社会支持是分娩恐惧的预测因素。医护人员应重视剖宫产后再次妊娠且有较高分娩恐惧风险的妇女，在妊娠期间提供相应的服务。
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