量化杜拉护理与母亲和新生儿的结果之间的关联
Lara S Lemon1, Beth Quinn2, Melissa Young2
1Department of Obstetrics, Gynecology and Reproductive Sciences, Magee-Womens Hospital, University of Pittsburgh School of Medicine, Pittsburgh, PA; Department of Clinical Analytics, University of Pittsburgh Medical Center, Pittsburgh, PA; Magee-Womens Research Institute, University of Pittsburgh School of Medicine, Pittsburgh, PA.
杜拉护理改善了母亲和婴儿的结果,增加了剖腹产和产后访问出席后的阴道分娩. 这种支持也提高了母乳养率,减少了早产,在不同的人口中显示出一致的好处.
科学领域:
- 孕产妇和胎儿的医学
- 公共卫生 公共卫生
- 医疗服务研究 医疗服务研究
背景情况:
- 美国日益严重的孕产妇死亡率和种族差异需要进行干预.
- 杜拉被认为是改善母亲和婴儿健康结果的潜在资源.
- 这项研究解决了评估杜拉护理对不同患者群体的影响的需要.
研究的目的:
- 评估杜拉护理与母亲/新生儿结局之间的关联.
- 检查杜拉护理在不同亚群的有效性,包括按种族和保险状况.
- 提供关于杜拉支持在缓解孕产妇健康差异方面的作用的证据.
主要方法:
- 17,831次分娩 (2021-2022) 的回顾性队列研究.
- 比较了接受杜拉护理的患者与没有接受杜拉护理的患者的结局.
- 使用多变量逻辑回归和倾向得分方法进行调整分析.
- 按种族 (白人与黑人) 和付款人身份 (公共与商业) 分层分析.
主要成果:
- 杜拉护理与剖腹产后阴道分娩率的增加有关 (aRD 15.6-34.2).
- 产后办公室访问出席率 (aRD 5.4-6.8) 和纯母乳养率 (aRR 1.22) 在杜拉支持下更高.
- 杜拉护理与早产率的减少有关 (aRD -3.8至 -4.0).
- 调查结果在种族和保险群体中保持一致.
结论:
- 杜拉护理与改善母亲和新生儿的结果有关,包括剖腹产后更高的阴道分娩率,产后访问出席率和母乳养.
- 杜拉的支持也与早产减少有关.
- 杜拉护理的积极影响在不同种族和保险群体中得到了一致的观察,突出了其减少健康差异的潜力.
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