在分娩期间进行区域止痛后的产周结果
Janna Lawson1, Lahiru Amaratunge2, Melody Goh3
1The Ritchie Centre, Department of Obstetrics and Gynaecology, Monash University, Melbourne, Victoria, Australia.
The Australian & New Zealand journal of obstetrics & gynaecology
|February 13, 2024
概括
在分娩期间的区域性镇痛与仪器分娩,剖腹产和新生儿不良结果的风险增加有关. 这些发现强调需要在疼痛管理决策中仔细考虑风险和益处.
科学领域:
- 产科和妇科 产科和妇科
- 围产儿医学 围产儿医学
- 疼痛管理 疼痛管理
背景情况:
- 区域性镇痛是一种在分娩期间缓解疼痛的常见方法.
- 对于与其使用相关的潜在的孕产妇和新生儿不良后果存在担忧.
研究的目的:
- 调查区域止痛与母亲和新生儿健康结果之间的关联.
- 为风险-收益讨论和分工疼痛管理中的共享决策提供数据.
主要方法:
- 澳大利亚维多利亚州 (2014-2020年) 的回顾性基于人口的队列研究.
- 带有和没有区域止痛药的单期分娩的比较.
- 使用多变量逻辑和线性回归分析.
主要成果:
- 区域性止痛与仪器分娩 (aOR=3.59) 和剖腹产 (aOR=2.30) 的更高率有关.
- 延长第二阶段分娩的风险增加 (26.6分钟),APGAR分数较低 (aOR=1.30),以及新生儿复苏 (aOR=1.44).
- 与增加对配方奶粉的需求 (aOR=1.68) 和在出院时非专属母乳养 (aOR=1.59) 相关.
结论:
- 劳动区域止痛与不利的孕产妇和新生儿结果有关.
- 调查结果支持对区域止痛药的风险和益处进行知情讨论.
- 进一步的前性研究和随机对照试验是有必要的.
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