在COVID-19大流行之前和期间,计划在家分娩的预测因素
Allison K Crockett1,2, Bethany F Laden1, Dmitry Tumin3
1Department of Obstetrics and Gynecology, Brody School of Medicine, East Carolina University, Greenville, NC, USA.
Journal of perinatal medicine
|January 31, 2024
概括
在COVID-19大流行期间,计划的家庭分娩增加了50%以上,显示出社会经济多样性的增加. 家庭分娩预测因素的人口差异有所减少,而临床风险因素仍然倾向于医院分娩.
科学领域:
- 生殖健康 生殖健康
- 公共卫生 公共卫生
- 流行病学 流行病学
背景情况:
- "COVID-19"大流行严重影响了医疗保健的获取和个人健康决策.
- 了解分娩地点偏好的变化,例如计划在家分娩,对于公共卫生至关重要.
- 关于家庭分娩预测指标的流行前数据为评估流行时代变化提供了基线.
研究的目的:
- 分析自COVID-19流行病爆发以来,美国计划家庭分娩的人口和临床预测因素的变化.
- 为了比较2019年大流行前一年和2021年大流行时代之间的家庭分娩趋势.
主要方法:
- 一项基于人口的回顾性队列研究利用了美国国家生命统计局的出生证明数据.
- 分析了18岁以上女性的2019年 (大流行前) 和2021年 (大流行时代) 的出生记录.
- 单变量和多变量逻辑回归检查了出生地点 (计划家庭与医院) 和与研究年共变量相互作用.
主要成果:
- 计划在家分娩的比例从2019年的0.82%增加到2021年的1.24%,这是统计学上显著的增长.
- 五个人口变量 (种族/种族,年龄,教育,平等,WIC参与) 与年份有显著的相互作用,表明2021年差异减少.
- 临床风险因素仍然是医院分娩的强有力的预测因素,没有证据表明大流行时期家庭分娩的临床风险增加.
结论:
- 在大流行期间,计划在家分娩的数量大幅增加,超过50%.
- 流行病时代的家庭分娩队列与流行病前时期相比,表现出更大的社会经济多样性.
- 临床风险因素继续与医院分娩有关,而大流行时期家庭分娩的临床风险概况没有恶化.
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