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在一项初产妇队列研究中,调查早产发作症状与自我诊断的分娩发作之间的关联。

Investigating the associations between early labour onset symptoms and self-diagnosed labour onset in a cohort study of primiparas.

作者信息

Gehling Hanna, Spineli Loukia M, Gross Mechthild M

机构信息

Midwifery Research and Education Unit, Hannover Medical School, Carl-Neuberg-Str.1, 30625 Hannover, Germany.

出版信息

Sex Reprod Healthc. 2024 Dec;42:101033. doi: 10.1016/j.srhc.2024.101033. Epub 2024 Sep 10.

Abstract

OBJECTIVE

The early recognition of possible labour onset symptoms may be pivotal to identifying the beginning of early labour and are usually recognised by the birthing women themselves. The present study illustrates the interrelationship among five labour-onset symptoms and explores the association of these labour-onset symptoms with the self-diagnosed labour onset of primiparas.

METHODS

A prospective cohort study on a sample of 69 primigravida in Giessen, Germany, expecting spontaneous onset of labour at term. The participants filled in a diary from ≥37 + 0 weeks gestation until self-diagnosed labour onset. Descriptive, bivariate and inferential analysis explored association of labour onset symptoms with self-diagnosed labour onset while accounting for maternal and newborn characteristics.

RESULTS

Self-diagnosed labour onset was positively associated with all symptoms and clinical characteristics, apart from irregular pain and maternal weight and age. Moreover, regular pain was negatively correlated with irregular pain; having regular pain increased the odds of self-diagnosed labour onset substantially (OR: 10.18, 95 % CI: 2.39-66.27), followed by gastrointestinal symptoms (OR: 2.07, 95 % CI: 0.40-13.10) and emotional symptoms (OR: 2.05, 95% CI: 0.30-13.98).

CONCLUSION

Being the initiator of intrapartum care without any birth experience, primiparas are prone to experiencing dissatisfaction in care and may enter professional care too late or too early. The present study showed that regular pain may signify primiparas to self-diagnose labour onset within 24 h and indicate early labour symptoms that may be relevant for a self-diagnosed labour onset.

摘要

目的

尽早识别可能的分娩开始症状对于确定早产的开始可能至关重要,而且通常由产妇自己识别。本研究阐述了五种分娩开始症状之间的相互关系,并探讨了这些分娩开始症状与初产妇自我诊断的分娩开始之间的关联。

方法

对德国吉森市69例单胎初产妇进行前瞻性队列研究,这些产妇预期足月自然分娩。参与者从妊娠≥37+0周开始填写日记,直至自我诊断为分娩开始。描述性、双变量和推断性分析探讨了分娩开始症状与自我诊断的分娩开始之间的关联,同时考虑了母亲和新生儿的特征。

结果

自我诊断的分娩开始与所有症状和临床特征呈正相关,但不包括不规则疼痛、母亲体重和年龄。此外,规律性疼痛与不规则疼痛呈负相关;出现规律性疼痛会大幅增加自我诊断的分娩开始的几率(比值比:10.18,95%置信区间:2.39-66.27),其次是胃肠道症状(比值比:2.07,95%置信区间:0.40-13.10)和情绪症状(比值比:2.05,95%置信区间:0.30-13.98)。

结论

作为没有任何分娩经验的产时护理发起者,初产妇容易对护理感到不满,可能过晚或过早进入专业护理。本研究表明,规律性疼痛可能意味着初产妇在24小时内自我诊断为分娩开始,并表明可能与自我诊断的分娩开始相关的早产症状。

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