产后护理的分娩策略:系统审查和元分析
Ian J Saldanha1, Gaelen P Adam, Ghid Kanaan
1Center for Clinical Trials and Evidence Synthesis, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; the Center for Evidence Synthesis in Health, the Department of Health Services, Policy, and Practice, and the Department of Epidemiology, Brown University School of Public Health, and the Departments of Emergency Medicine, Pediatrics, Medicine, and Obstetrics and Gynecology, Brown University Warren Alpert Medical School, Providence, Rhode Island; the Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan; the Center for Outcomes Research and Evaluation, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut; and the Department of Obstetrics and Gynecology, University of North Carolina School of Medicine, Chapel Hill, North Carolina.
这项系统性审查发现,虽然一些产后护理策略显示出希望,但需要更多的研究来确定改善孕产妇健康结果和医疗保健利用的最有效方法.
科学领域:
- 生殖健康 生殖健康
- 孕产妇健康 孕产妇健康
- 医疗保健提供系统
背景情况:
- 产后护理对于母亲的福祉至关重要.
- 有效的医疗保健提供策略对于优化母亲的结果至关重要.
- 关于各种产后护理策略的影响的证据各不相同.
研究的目的:
- 系统地审查产后医疗保健提供策略对医疗保健利用和孕产妇结果的影响.
- 综合来自各种研究设计的关于常规产后护理干预措施的证据.
- 确定产后护理服务的未来研究领域.
主要方法:
- 从美国和加拿大的研究开始到2022年11月的系统审查.
- 搜索了多个数据库,包括Medline,EMBASE,CENTRAL,CINAHL和clinicalTrials.gov.gov. 这些数据库.
- 包括64项符合条件的研究 (50项RCT,14项非RCT),重点关注医疗保健利用率和孕产妇结果.
主要成果:
- 早期避孕护理增加了植入物使用;同行支持和哺乳顾问护理改善了母乳养率.
- 护理地点和整合策略对心理健康或物质使用的影响有限.
- 测试提醒提高了对特定查测试的遵守.
结论:
- 某些产后护理策略,如提供早期避孕和同行支持,显示出积极的影响.
- 需要进一步的研究,以建立最有效的护理提供模式,以全面改善产后健康.
- 这些发现强调了需要量身定制的战略,以提高产后医疗保健利用率和结果.
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