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The Impact of Labor-Delivery-Recovery-Postpartum (LDRP) Care Model on Delivery Outcomes: A Single-Center
1Department of Obstetrics, Tianjin Central Hospital of Gynecology Obstetrics, Tianjin, People's Republic of China.
Study Design:
This single-center retrospective cohort study compared parturients undergoing delivery under the Labor-Delivery-Recovery-Postpartum (LDRP) model (n=901) with those in traditional delivery rooms (n=2863) to evaluate differences in key obstetric outcomes. The study was conducted at Tianjin Central Maternity and Child Health Hospital (Heping Campus) from July 2023 to August 2024.
Participants And Data:
A total of 3764 eligible parturients (age ≥18 years) were enrolled, with all data systematically extracted from the hospital's electronic medical record system. Collected variables included demographic, obstetric, neonatal, and delivery-related parameters.
Statistical Analysis:
Given the non-randomized group assignment (based on patient preference and financial capacity), 1:1 propensity score matching (PSM) with a 0.02 caliper was employed to balance baseline characteristics, including maternal age, gestational weeks, epidural analgesia use, parity, complications, neonatal sex, and birth weight, resulting in 900 matched pairs per group. Categorical variables are presented as counts/percentages, and continuous variables as medians with 5th-95th percentile ranges. Post-matching, χ2 -tests compared outcomes, and binary logistic regression identified independent risk factors.
Results:
After PSM, the LDRP group demonstrated significantly lower rates of vaginal operative delivery (χ2=19.393, p<0.001) and postpartum hemorrhage (χ2=19.498, p<0.001) compared to the traditional delivery group. No significant difference was observed in intrapartum cesarean delivery rates (χ2=0.147, P=0.701). Multivariate analysis identified delivery in a traditional room (OR=1.990, 95% CI 1.478-2.677), along with neonatal birth weight (OR = 1.146, P = 0.016, 95% CI 1.020-1.218) and maternal age (OR = 1.068, P = 0.001, 95% CI 1.026-1.111), as independent risk factors for postpartum hemorrhage. For intrapartum cesarean delivery, independent risk factors included gestational weeks (OR = 1.913, P<0.001, 95% CI 1.485-2.465), number of deliveries (OR = 0.190, P <0.001, 95% CI 0.092-0.394), the presence of complications (OR = 2.358, P<0.001, 95% CI 1.768-3.144) and the duration of labor (OR = 1.059, P<0.001, 95% CI 1.034-1.085). Delivery location was also an independent factor associated with reduced operative vaginal delivery (OR=0.224, 95% CI 0.111-0.454).
Conclusion:
The findings suggest that the LDRP delivery model is independently associated with a lower incidence of postpartum hemorrhage and operative vaginal delivery. This indicates that the integrated, continuous-care structure of the LDRP model may contribute positively to maternal delivery outcomes and postpartum recovery experience.