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产妇分娩经历对后续分娩的影响:芬兰初产妇的回顾性 7 年队列研究。

Effect of the maternal childbirth experience on a subsequent birth: a retrospective 7-year cohort study of primiparas in Finland.

机构信息

Public Health, University of Helsinki Faculty of Medicine, Helsinki, Finland

Department of Obstetrics and Gynecology, Helsinki University Hospital, Helsinki, Finland.

出版信息

BMJ Open. 2023 Mar 9;13(3):e069918. doi: 10.1136/bmjopen-2022-069918.

Abstract

OBJECTIVE

To study the effect of the childbirth experience on the likelihood and interval to a subsequent live birth.

DESIGN

Retrospective analysis of a 7-year cohort.

SETTING

Childbirths in Helsinki University Hospital delivery units.

PARTICIPANTS

All parturients giving birth to a term and living baby from a single pregnancy in Helsinki University Hospital delivery units from January 2012 to December 2018 (n=120 437). Parturients delivering their first child (n=45 947) were followed until the birth of a subsequent child or the end of 2018.

MAIN OUTCOME MEASURE

The interval to a subsequent childbirth connected to the experience of the first childbirth was the primary outcome of the study.

RESULTS

A negative first childbirth experience decreases the likelihood of delivering a subsequent child during the follow-up (adjusted HR=0.81, 95% CI 0.76 to 0.86) compared with those experiencing the first childbirth as positive. For parturients with a positive childbirth experience, the median interval to a subsequent delivery was 3.90 years (3.84-3.97) compared with 5.29 years (4.86-5.97) after a negative childbirth experience.

CONCLUSION

The negative childbirth experience influences reproductive decisions. Consequently, more focus should be placed on understanding and managing the antecedents of positive/negative childbirth experiences.

摘要

目的

研究分娩经历对再次活产的可能性和间隔时间的影响。

设计

7 年队列的回顾性分析。

地点

赫尔辛基大学附属医院分娩单位。

参与者

2012 年 1 月至 2018 年 12 月期间在赫尔辛基大学附属医院分娩单位分娩足月活产婴儿的单胎妊娠产妇(n=120437)。随访至首次分娩后再次分娩或 2018 年底的产妇(n=45947)。

主要观察指标

与首次分娩经历相关的再次分娩间隔时间是本研究的主要结局。

结果

与经历积极分娩的产妇相比,消极的首次分娩经历会降低在随访期间再次分娩的可能性(调整后的 HR=0.81,95%CI 0.76-0.86)。对于经历积极分娩的产妇,中位再次分娩间隔时间为 3.90 年(3.84-3.97),而经历消极分娩的产妇为 5.29 年(4.86-5.97)。

结论

消极的分娩经历会影响生育决策。因此,应更加关注理解和管理积极/消极分娩经历的前因。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d543/10008220/d50ff7b83dec/bmjopen-2022-069918f01.jpg

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