无痛分娩对自然分娩初产妇母婴结局、预后指标及焦虑抑郁的影响

Effects of painless delivery on pregnancy outcomes,prognostic indexes and anxiety depression in primiparas with natural delivery

目的 研究自然分娩初产妇接受无痛分娩后对母婴结局、预后相关指标及焦虑抑郁的影响。方法 纳入2021年1~8月因到预产期入院的初产妇1 320例产妇纳入,随机数字表法分作无痛组及传统组,每组660例。传统组产妇实施传统自然分娩,无痛组产妇则接受无痛分娩。分析2组产妇产程及产后出血量,疼痛程度,分娩结局,产妇心理状态等方面的差异。结果 无痛组第一、第二、第三产程均短于传统组(P<0.05);2组产后出血量比较,差异无统计学意义(P>0.05)。无痛组疼痛程度为1级、2级人数占比均显著高于传统组,而3级、4级人数占比均显著低于传统组(P<0.05)。无痛组胎儿窘迫、新生儿窒息发生率,均低于传统组(P<0.05);2组新生儿1、5 min Apgar评分(P>0.05)。无痛组产妇SAS、SDS评分均低于传统组(P<0.05)。结论 自然分娩初产妇接受无痛分娩后产程显著缩短,产后出血量减少,胎儿窘迫、新生儿窒息发生风险明显降低,且产妇心理状态相对较佳。

Objective To study the effects of painless delivery on pregnancy outcomes,prognostic indexes and anxiety depression in primiparas with natural delivery.Methods A total of 1320 primiparas who were admitted to the hospital from January 2021 to August 2021 due to expected date of delivery were included in the study.The patients received to either traditional natural delivery(traditional group,n=660)or painless delivery(painless group,n=660).The key observation was intrapartum and postpartum hemorrhage,pain degree,delivery outcome,and maternal psychological state between the both groups.Results The first,second and third stages of labor in painless group were significantly shorter than those in the traditional group(all P<0.05).There was no significant difference in postpartum hemorrhage between the two groups(P>0.05).The proportion of pain degree with grade 1~2 in painless group was significantly higher than that in traditional group,while the proportion of pain degree with grade 3~4 in painless group was significantly lower(all P<0.05).The incidence of fetal distress and neonatal asphyxia in painless group were significantly lower than those in traditional group(both P<0.05).There was no significant difference in Apgar score(1min,5min)between the two groups(all P>0.05).Self-Rating Anxiety/Depression Scale(SAS/SDS)scores were significantly lower than those in the traditional group(all P<0.05).Conclusion For primiparas with natural delivery,painless delivery can significantly shorten the labor process,reduce postpartum hemorrhage,decrease the risk of fetal distress and neonatal asphyxia,and it makes maternal psychological state relatively better.