摘要
目的 了解本院单胎初产妇分娩恐惧情况并探讨分娩恐惧对妊娠结局的影响.为进一步改善孕期保健服务,改善母儿结局提供理论依据.方法 纳入2021年10月1日-2022年10月31日在山西医科大学第一医院产科规律产检并分娩的单胎初产妇617例为研究对象.在孕妇来院产检时对其进行问卷调查,并根据相关信息获取分娩时信息:孕周、分娩方式、产后出血量、产程、住院天数等资料,分析不同程度分娩恐惧对妊娠结局的影响.结果 本研究共调查617例孕妇,存在分娩恐惧的孕妇有461例,发生率为74.7％.随着分娩恐惧程度的加深,自然分娩率逐渐降低,非医学指征剖宫产发生率逐渐升高,差异具有统计学意义(P＜0.05).各组在妊娠总天数、早产儿发生率、产后2 h出血量、产后出血发生率、Apgar评分、新生儿体重、低出生体重儿、产后住院天数,非医学指征剖宫产发生率方面,差异均有统计学意义(P＜0.05),主要体现在中、重度分娩恐惧组.在总产程、巨大儿发生率、会阴侧切率、中转剖宫产发生率方面,差异无统计学意义(P＞0.05).结论 本院分娩恐惧发生率相对较高,分娩恐惧会增加不良母婴结局的发生率,提高剖宫产率,应重视孕期女性心理健康教育,提高孕期综合保健服务.
Abstract
Objective To investigate the fear of childbirth of single primipara in our hospital and to explore the influence of fear of childbirth on pregnancy outcome.To provide theoretical basis for further improving pregnancy care services and maternal and infant outcomes.Methods From October 1,2021 to October 31,2022,a total of 617 single primiparas who received regular birth examination and gave birth in the Department of Obstetrics,the First Hospital of Shanxi Medical University were included as subjects.A questionnaire survey was conducted on pregnant women when they came to the hospital for obstetrical examination,and information about childbirth was obtained according to relevant information,including gestational week,delivery mode,postpartum blood loss,labor process,length of stay,etc.,to analyze the influence of different degrees of fear of childbirth on pregnancy outcomes.Results A total of 617 pregnant women were investigated in this study.There were 461 pregnant women with fear of childbirth,with an incidence rate of 74.7％.With the deepening of fear of childbirth,the rate of natural delivery gradually decreased,and the incidence of non-medical indications of caesarean section gradually increased,the difference was statistically significant(P＜0.05).There were statistically significant differences among all groups in total gestation days,incidence of premature infants,2h postpartum blood loss,postpartum hemorrhage rate,Apgar score,neonatal weight,low birth weight infants,postpartum hospital stay days,and incidence of non-medical indications of cesarean section(P＜0.05),which mainly affected the moderate and severe fear of childbirth group.There were no significant differences in the total labor course,the incidence of macrosomia,the rate of lateral perineal resection and the incidence of cesarean section transfer(P＞0.05).Conclusion The incidence of fear of childbirth is relatively high in our hospital.Fear of childbirth can increase the incidence of adverse maternal and infant outcomes and increase the rate of cesarean section.We should pay attention to the mental health education of pregnant women and improve the comprehensive health care services during pregnancy.
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