孕晚期干预支持对孕妇产时认知行为及分娩结局的影响

Effect of third trimester intervention on primiparas' childbirth knowledge,attitude,behaviors and childbirth outcomes

目的探讨孕晚期干预支持对孕妇产时认知行为及分娩结局的影响。方法选择在妇产医院建卡并定期产检的初产妇100例,分为观察组和对照组,每组50例。观察组除接受常规产前检查和孕期指导外,还在孕晚期参加互动式分娩教育课程,对照组只进行常规产前检查和孕期指导。比较两组认知行为情况、分娩方式、产后2h出血量、新生儿Apgar评分等。结果干预前两组分娩知识与态度得分的差异无统计学意义(P>0.05);干预后观察组分娩知识、态度及产时行为得分均高于对照组,差异有统计学意义(P<0.01或P<0.05)。观察组阴道分娩率高于对照组,产后2h出血量也少于对照组,差异有统计学意义(P<0.05),两组新生儿Apgar评分差异无统计学意义(P>0.05)。结论孕晚期干预支持可有效促进孕妇产时认知行为,在一定程度上改善了分娩结局,提高了孕产妇及家属的满意度,从而进一步保护、支持并促进自然分娩,提升孕产妇对分娩的正性体验。

Objective To explore the effect of third trimester intervention on primiparas＇ childbirth knowledge,attitude,behaviors and childbirth outcomes.Methods One hundred primiparas who had made registrations in Obstetrics Gynecology Hospital of Fudan University were randomly divided into two groups,with 50 women in each group.The primiparas in the control group received routine antenatal examinations.In addition,the primiparas in the experimental group received a special course named ＂easy birth＂ during the third trimester.The primiparas＇ childbirth knowledge,attitude and behaviors,delivery mode,2 hours postpartum hemorrhage,neonatal Apgar scores were compared between the two rgoups.Results Before the intervention,there were no significant differences in the scores of childbirth knowledge and attitude（P0.05）.After the intervention,the scores of childbirth knowledge,attitude and behavior in the experimental group were significantly higher than that in the control group（P0.01 or P0.05）.Compared with the control group,the rate of vaginal birth in the experimental group was significantly higher（P0.05）and the amount of 2 hours postpartum hemorrhage was lower（P0.05）.Conclusions The interventions and support in third trimester can effectively promote primiparas＇ childbirth knowledge,attitude and behavior,improve the birth outcomes to some extent,increase the satisfaction of primiparas and their family members,and thus promoting natural birth and enhancing women＇s positive experience of childbirth.