Hooper Emily, Mechkaroff Olivia, Upitis Aurora, Schofield Emma, Carland Jane Ellen, Henry Amanda
School of Clinical Medicine, Rural Clinical Campus, Faculty of Medicine and Health, University of New South Wales, Port Macquarie, Australia.
School of Clinical Medicine, Rural Clinical Campus, Faculty of Medicine and Health, University of New South Wales, Port Macquarie, Australia.
Women Birth. 2025 Jan;38(1):101843. doi: 10.1016/j.wombi.2024.101843. Epub 2025 Jan 2.
The World Health Organisation has suggested antenatal education be integrated within standard antenatal care. However, evidence for the impact of antenatal education varies. This systematic review and meta-analysis evaluated randomised controlled trial evidence regarding the influence of antenatal education on labour and birth outcomes.
Electronic databases (CINAHL, PubMed, Embase and Scopus) were searched for randomised controlled trials published between 2011 and 2023. Primary outcomes were mode of birth, epidural analgesia use, and induction of labour. Subgroup analysis by type of education (general education, specific technique, birth plan use) was performed. Three authors reviewed studies and extracted data. Risk of bias was assessed using the Cochrane Risk of Bias 2 tool. Meta-analysis was performed using RevMan.
Seventeen studies (n=7260 participants) were included, most (n=10) had low risk of bias. Antenatal education was associated with decreased rates of planned caesarean sections (Relative Risk (RR) 0.87; 95 % confidence interval (CI), 0.83-0.92, I=0 %), but not unplanned caesareans (RR 0.99; 95 % CI, 0.88-1.12, I=0 %),as well as increased vaginal births (RR 1.14; 95 % CI 1.07-1.21, I=79 %) and increased spontaneous onset of labour (n=10 studies, RR, 1.07; 95 % CI, 1.01-1.14, I=0 %). Epidural analgesia use (RR, 0.88; 95 % CI, 0.88-1.00, I=78 %) was not significantly affected. General education and birth plan care interventions were found to be more effective than specific technique care.
Antenatal education programs studied improve some labour and birth outcomes, although with substantial heterogeneity regarding mode of birth and epidural analgesia use findings. General education appeared more effective than specific technique education.
世界卫生组织建议将产前教育纳入标准产前护理中。然而，产前教育影响的证据各不相同。本系统评价和荟萃分析评估了关于产前教育对分娩及分娩结局影响的随机对照试验证据。
检索电子数据库（CINAHL、PubMed、Embase和Scopus），查找2011年至2023年发表的随机对照试验。主要结局为分娩方式、硬膜外镇痛的使用和引产。按教育类型（一般教育、特定技术、使用分娩计划）进行亚组分析。三位作者对研究进行了审查并提取了数据。使用Cochrane偏倚风险2工具评估偏倚风险。使用RevMan进行荟萃分析。
纳入了17项研究（n = 7260名参与者），大多数（n = 10）偏倚风险较低。产前教育与计划剖宫产率降低相关（相对风险（RR）0.87；95%置信区间（CI），0.83 - 0.92，I = 0%），但与非计划剖宫产无关（RR 0.99；95% CI，0.88 - 1.12，I = 0%），同时阴道分娩增加（RR 1.14；95% CI 1.07 - 1.21，I = 79%）以及自然发动分娩增加（n = 10项研究，RR，1.07；95% CI，1.01 - 1.14，I = 0%）。硬膜外镇痛的使用（RR，0.88；95% CI，0.88 - 1.00，I = 78%）未受到显著影响。发现一般教育和分娩计划护理干预比特定技术护理更有效。
所研究的产前教育项目改善了一些分娩及分娩结局，尽管在分娩方式和硬膜外镇痛使用结果方面存在很大异质性。一般教育似乎比特定技术教育更有效。
