在助产后的婴儿急诊室使用与产科医生带领的产周护理:基于人口的队列研究
Joel G Ray1,2,3, Sho Podolsky1, Carla Sorbara4
1ICES, Toronto, Ontario, Canada.
BJOG : an international journal of obstetrics and gynaecology
|August 27, 2025
概括
在接受助产护理的低风险母亲的婴儿中,婴儿急诊室 (ED) 访问的次数明显低于产科护理. 这表明更多的助产服务可以减少产后新生儿的医疗利用率.
科学领域:
- 母婴健康
- 提供医疗服务的模式
- 公共卫生研究
背景情况:
- 产妇护理模式的选择会影响产后婴儿的健康状况和资源利用.
- 对于优化医疗保健系统而言, 了解助产士和产科护理之间的急诊室使用差异至关重要.
研究的目的:
- 根据助产士和产科的护理模式来比较婴儿急诊室 (ED) 的使用情况.
- 评估不同产妇护理模式对低风险新生儿产后医疗资源使用的影响.
主要方法:
- 在加拿大安大略省进行了以人口为基础的回顾性队列研究.
- 包括2012年至2021年间出生于低风险初生妇女的婴儿,将助产士主导的护理 (n=36,949) 与产科主导的护理 (n=120,463) 进行比较.
- 用修改Poisson回归与倾向分数加权来分析婴儿在产后27天的非预定的ED访问.
主要成果:
- 与接受产科护理的婴儿相比,接受助产护理的婴儿在分娩后27天内患急诊的风险降低了49% (相对风险[RR]0.51,95%置信区间[CI]0.49至0.54).
- 在产后7天内进行检查时,风险降低更为明显 (RR 0. 42,95% CI 0. 39- 0. 46).
- 与产科护理患者 (9. 9%) 相比,产科护理患者的急诊次数较少 (4. 8%).
结论:
- 与产科护理相比,产妇模式护理与低风险初胎妇女产生的婴儿急诊室使用率降低有关.
- 扩大获得助产护理的机会可能会减少新生儿产后医疗资源的使用.
- 这些发现突显了助产护理在改善低风险母婴双人组的医疗效率和结果方面的潜力.
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