Heim Maria A, Makuch Maria Y
Department of Obstetrics and Gynecology, University of Campinas Faculty of Medical Sciences, Sao Paulo, Brazil.
Campinas Reproductive Health Research Center, Sao Paulo, Brazil.
Eur J Midwifery. 2024 Jan 18;8. doi: 10.18332/ejm/175927. eCollection 2024.
The aim of this study was to evaluate a short educational intervention that focused on labor pain (through visual analogue scale, VAS), postpartum anxiety, and birthing experience before and during the SARS-CoV-2 (COVID-19) pandemic.
This was a quasi-experimental study conducted between November 2019 and May 2021 in Brazil in 100 women with a high-risk pregnancy in the third trimester of pregnancy with an intervention group with in-person or virtual sessions (during the COVID-19 pandemic) and a non-intervention group. The antenatal intervention included breathing and relaxation techniques, upright positions, and information about labor. For evaluation, an antenatal questionnaire, State-Trait Anxiety Inventory (STAI) and a postpartum questionnaire were used. For data analysis, Student's t-test, chi-squared and Fisher's exact tests, ANOVA, bivariate, and multivariate regression analysis, were used.
When comparing the women in the intervention group to the non-intervention group, it was observed that the latter group reported higher fear of pain at labor during antenatal consultations (p<0.013); more women needed analgesia at 0-4 cm dilation (17/40) (p<0.018); the duration of labor was ≥12 hours (37/50) (p<0.037); while the intervention reported having a regular, good or excellent labor period (36/50) (p=0.014). The multiple regression analysis for labor pain showed a significant relationship between mode of delivery (cesarean delivery: RR; SE -21.43; 5.32, p<0.001) and labor pain, and good satisfaction with labor (RR; SE -13.86; 6.40, p=0.033).
Women from the intervention group had more satisfaction and less pain during labor than women from the non-intervention group.
本研究的目的是评估一项短期教育干预措施，该措施聚焦于严重急性呼吸综合征冠状病毒2（SARS-CoV-2，即新型冠状病毒肺炎）大流行之前及期间的分娩疼痛（通过视觉模拟评分法，VAS）、产后焦虑和分娩体验。
这是一项准实验研究，于2019年11月至2021年5月在巴西对100名妊娠晚期高危孕妇进行，分为干预组（在新型冠状病毒肺炎大流行期间进行面对面或虚拟课程）和非干预组。产前干预包括呼吸和放松技巧、直立姿势以及分娩相关信息。评估时使用了一份产前问卷、状态-特质焦虑量表（STAI）和一份产后问卷。数据分析采用了学生t检验、卡方检验和费舍尔精确检验、方差分析、双变量和多变量回归分析。
将干预组女性与非干预组女性进行比较时发现，后者在产前咨询时报告对分娩疼痛的恐惧更高（p<0.013）；更多女性在宫口扩张0至4厘米时需要镇痛（17/40）（p<0.018）；产程持续时间≥12小时（37/50）（p<0.037）；而干预组报告有规律、良好或优秀的产程（36/50）（p=0.014）。分娩疼痛的多变量回归分析显示，分娩方式（剖宫产：RR；SE -21.43；5.32，p<0.001）与分娩疼痛以及对分娩的良好满意度之间存在显著关系（RR；SE -13.86；6.40，p=0.033）。
与非干预组女性相比，干预组女性在分娩期间的满意度更高，疼痛更少。
