School of Health Sciences, Institute of Midwifery, ZHAW Zurich University of Applied Sciences, Winterthur, Switzerland.
Faculty of Medicine, University of Zurich, Zurich, Switzerland.
BMC Pregnancy Childbirth. 2022 Nov 19;22(1):856. doi: 10.1186/s12884-022-05178-w.
Several studies have investigated the relationship between antenatal education classes and pregnancy outcomes. These studies have shown positive effects on mothers, such as a lower epidural rate in the intervention groups. However, until now, the impact on outcomes for mothers and newborns of antenatal education classes that focus on breathing and relaxation techniques has not been examined.
Investigate the effects of skilled breathing and relaxation techniques provided in antenatal education classes on maternal and neonatal birth outcomes.
The protocol for this study was registered with PROSPERO (ID: CRD42020192289). A systematic literature search was undertaken and completed in January 2022, using the databases MEDLINE, CINAHL, clinicalTrials.gov, Cochrane Library, Embase and MIDIRS according to a priori formulated PICO criteria: population (pregnant women), intervention (antenatal education classes with integrated breathing and relaxation techniques), comparison (antenatal education classes that do not include skilled breathing and relaxation techniques), and outcome (maternal and neonatal outcomes). The quality of the studies was assessed by two reviewers using the standardised instruments RoB 2 and ROBINS-I.
Ten studies were included in this review, nine randomised controlled trials and one quasi-experimental study. The results indicate that skilled breathing and relaxation techniques may positively influence self-efficacy, the need for pharmacological support, specifically the use of epidural anaesthesia, and the memory of labour pain. No effects were found in relation to predefined neonatal outcomes. The quality of evidence on maternal and neonatal outcomes is inconsistent across studies, as different antenatal education classes with varying interventions, including breathing and relaxation techniques, were offered in the studies.
Women who attended an antenatal education class with breathing and relaxation techniques appear to benefit from the intervention. This applies to the practical implementation and use of breathing and relaxation techniques during labour, increased self-confidence and self-efficacy, and a increased feeling of being in control during labour. This demonstrates the importance of information provision and a focus on breathing and relaxation techniques in antenatal education.
多项研究调查了产前教育课程与妊娠结局之间的关系。这些研究表明，干预组的硬膜外使用率较低等母亲受益。然而，到目前为止，还没有研究过专注于呼吸和放松技术的产前教育课程对母婴分娩结局的影响。
调查产前教育课程中提供的熟练呼吸和放松技术对产妇和新生儿分娩结局的影响。
本研究的方案在 PROSPERO（ID：CRD42020192289）进行了注册。根据事先制定的 PICO 标准，我们进行了系统的文献检索，检索截止日期为 2022 年 1 月，使用的数据库包括 MEDLINE、CINAHL、clinicalTrials.gov、Cochrane 图书馆、Embase 和 MIDIRS：人群（孕妇）、干预（包含熟练呼吸和放松技术的产前教育课程）、对照（不包含熟练呼吸和放松技术的产前教育课程）和结局（产妇和新生儿结局）。两名评审员使用标准化工具 RoB 2 和 ROBINS-I 评估研究质量。
本综述纳入了 10 项研究，其中 9 项为随机对照试验，1 项为准实验研究。结果表明，熟练的呼吸和放松技术可能会对自我效能感、对药物支持的需求产生积极影响，特别是对硬膜外麻醉的使用，以及对分娩疼痛的记忆产生积极影响。但是，在预定的新生儿结局方面未发现效果。关于母婴结局的证据质量在研究之间不一致，因为研究中提供了不同的产前教育课程，干预措施也不同，包括呼吸和放松技术。
参加包含呼吸和放松技术的产前教育课程的女性似乎从干预中受益。这适用于分娩期间呼吸和放松技术的实际实施和使用、自我信心和自我效能感的提高，以及分娩时的控制感增强。这证明了在产前教育中提供信息和关注呼吸和放松技术的重要性。
