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药物止痛与女性分娩体验：一项系统综述

Pharmacological pain relief and women´s birth experience: a systematic review.

作者信息

Ugarph Edfeldt Malin, Gustavsson Hanne, Hildén Karin, Cao Yang, Backman Helena

机构信息

School of Medical Sciences, Örebro University, Örebro, SE, S-701 82, Sweden.

Department of Anaesthesia and Intensive Care, Region Örebro County, Orebro, S-701 85, Sweden.

出版信息

BMC Pregnancy Childbirth. 2025 Apr 26;25(1):505. doi: 10.1186/s12884-025-07602-3.

DOI:10.1186/s12884-025-07602-3
PMID:40287641
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12032825/
Abstract

BACKGROUND

There is increasing interest in health care systems worldwide for maternal satisfaction with childbirth experience. The World Health Organisation (WHO) launched a recommendation 2018 regarding women's right to equal and fair intrapartum care, where the importance of pharmacological pain relief was highlighted. Our objective with this systematic review was to summarize and assess the current knowledge regarding the impact of obstetric pharmacological pain relief on maternal satisfaction with childbirth.

METHODS

The databases Pub Med, Cochrane, EMBASE and CINAHL were searched for studies in the English language published after 1998 that investigated the effect of pharmacological pain relief on women´s birth experience after vaginal delivery. Studies reporting assessments of subjective satisfaction with childbirth in women planned for vaginal delivery were selected. The results were summarized narratively. For studies where comparable association measures were available, forest plots are presented. Due to heterogeneity of research questions and indirectness of measuring instruments, no meta-analyses were performed.

RESULTS

A total of 15,136 women were included from 18 studies. Two randomized controlled studies, nine cohort studies, six cross-sectional studies and one case control study, all had a moderate or high risk of bias. The studies used inconsistent methods to measure outcomes; therefore, no conclusion could be drawn regarding a possible correlation between pharmacological pain relief and overall birth experience.

CONCLUSIONS

This systematic review could not show a correlation between pharmacological pain relief and women´s experiences of childbirth, mainly due to large heterogeneity between studies. To evaluate pain relief during labour and improve women´s childbirth experiences, high-quality research is warranted.

TRIAL REGISTRATION

The study was registered in PROSPERO (prospective register of systematic reviews) 18 Dec 2018 (ID 116744).

摘要

背景

全球医疗保健系统对产妇分娩体验满意度的关注日益增加。世界卫生组织（WHO）于2018年发布了一项关于妇女获得平等和公平产时护理权利的建议，其中强调了药物止痛的重要性。我们进行这项系统评价的目的是总结和评估当前关于产科药物止痛对产妇分娩满意度影响的知识。

方法

在PubMed、Cochrane、EMBASE和CINAHL数据库中检索1998年后发表的英文研究，这些研究调查了药物止痛对阴道分娩后妇女分娩体验的影响。选择报告对计划阴道分娩妇女分娩主观满意度评估的研究。结果采用叙述性总结。对于有可比关联测量指标的研究，绘制森林图。由于研究问题的异质性和测量工具的间接性，未进行荟萃分析。

结果

18项研究共纳入15136名妇女。两项随机对照研究、九项队列研究、六项横断面研究和一项病例对照研究，均存在中度或高度偏倚风险。这些研究采用不一致的方法测量结果；因此，无法就药物止痛与总体分娩体验之间的可能相关性得出结论。

结论

这项系统评价未能显示药物止痛与妇女分娩体验之间的相关性，主要原因是研究之间存在较大异质性。为了评估分娩期间的止痛效果并改善妇女的分娩体验，高质量的研究是必要的。

试验注册

该研究于2018年12月18日在PROSPERO（系统评价前瞻性注册库）注册（ID 116744）。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f229/12032825/d8d95fffc212/12884_2025_7602_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f229/12032825/4c8f56825650/12884_2025_7602_Fig1_HTML.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f229/12032825/d8d95fffc212/12884_2025_7602_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f229/12032825/4c8f56825650/12884_2025_7602_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f229/12032825/8f895b50a475/12884_2025_7602_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f229/12032825/e61c73704cac/12884_2025_7602_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f229/12032825/8a1dff8f78f0/12884_2025_7602_Fig4_HTML.jpg
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