Fu Li, Huang Jing, Li Danxiao, Wang Huide, Xing Lili, Wei Tao, Hou Rui, Lu Hong
School of Nursing, Peking University, Beijing 100191, China.
Division of Care for Long Term Conditions, Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London SE1 8WA, UK.
Healthcare (Basel). 2023 Nov 20;11(22):2996. doi: 10.3390/healthcare11222996.
Existing research concerning the effects of the sitting birth position during the second stage of labour on maternal and neonatal outcomes remains controversial, and there is a lack of studies to explore its effect on the childbirth experience. The objective of this study is to explore whether the sitting birth position would influence maternal and neonatal outcomes, as well as the childbirth experience. The prospective cohort design was conducted in the study from February to June 2023, a total of 222 women (including primiparous women and multiparous women) were enrolled in our study, and they were divided into the sitting position cohort (n = 106) or the lithotomy position cohort (n = 116). The pre-designed questionnaire and Childbirth Experience Questionnaire (CEQ) were used for data collection during hospitalisation. Chi-square, Fisher's exact test, -tests, or the Mann-Whitney U test were utilised to assess differences between groups. Multivariate linear regression and logistic regression were employed to control possible confounders. The study found that primiparous women in the sitting position cohort had a shorter duration of the second stage of labour, higher spontaneous vaginal birth rates, lower episiotomy rates, and a better childbirth experience ( < 0.01). After adjusting for confounding factors through multiple linear and logistic regression analyses, the results remained consistent with those reported above. No neonate in each cohort had Apgar scores at 1 min and 5 min postpartum less than 7 or a Cord artery pH less than 7.00, regardless of parity. Based on the findings, we recommend that women could take the sitting birth position into account when giving birth for a positive childbirth experience, especially for primiparous women. The study could also serve as a reference for healthcare providers in the management of childbirth positions and the development of high-quality maternal care.
现有关于第二产程坐位分娩姿势对母婴结局影响的研究仍存在争议，且缺乏探讨其对分娩体验影响的研究。本研究的目的是探讨坐位分娩姿势是否会影响母婴结局以及分娩体验。本研究采用前瞻性队列设计，于2023年2月至6月进行，共纳入222名女性（包括初产妇和经产妇），她们被分为坐位队列（n = 106）或截石位队列（n = 116）。住院期间使用预先设计的问卷和分娩体验问卷（CEQ）收集数据。采用卡方检验、Fisher精确检验、t检验或Mann-Whitney U检验评估组间差异。采用多变量线性回归和逻辑回归控制可能的混杂因素。研究发现，坐位队列中的初产妇第二产程持续时间较短，自然阴道分娩率较高，会阴切开率较低，分娩体验较好（P < 0.01）。通过多元线性和逻辑回归分析调整混杂因素后，结果与上述报告一致。无论胎次如何，每个队列中均无新生儿产后1分钟和5分钟的Apgar评分低于7分或脐动脉pH值低于7.00。基于这些发现，我们建议女性分娩时可考虑采用坐位以获得积极的分娩体验，尤其是初产妇。本研究也可为医护人员在分娩姿势管理和高质量孕产妇护理发展方面提供参考。
