Systematic review and meta-analysis examining the effects of midwife care on cesarean birth

IF 2.8 3区医学 Q1 NURSING

Birth-Issues in Perinatal Care Pub Date : 2023-11-30 DOI:10.1111/birt.12801

Ilir Hoxha MD, PhD, Krenare Grezda MD, Anirudh Udutha MD, Besarta Taganoviq MS, Riaz Agahi PhD, Naime Brajshori PhD, Sharon Schindler Rising MSN, CNM, FACNM

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Abstract

Background

The increasing number of unnecessary cesarean births is a cause for concern and may be addressed by increasing access to midwifery care. The objective of this review was to assess the effect of midwifery care on the likelihood of cesarean births.

Methods

We searched five databases from the beginning of records through May 2020. We included observational studies that reported odds ratios or data allowing the calculation of odds ratios of cesarean birth for births with and without midwife involvement in care or presence at the institution. Standard inverse-variance random-effects meta-analysis was used to generate overall odds ratios (ORs).

Results

We observed a significantly lower likelihood of cesarean birth in midwife-led care, midwife-attended births, among those who received instruction pre-birth from midwives, and within institutions with a midwifery presence.

Conclusions

Care from midwives reduces the likelihood of cesarean birth in all the analyses, perhaps due to their greater preference and skill for physiologic births. Increased use of midwives in maternal care can reduce cesarean births and should be further researched and implemented broadly, potentially as the default modality in maternal care.

Abstract Image

查看原文本刊更多论文

检查助产士护理对剖宫产影响的系统回顾和荟萃分析。

背景:越来越多的不必要的剖宫产是一个值得关注的问题，可以通过增加获得助产护理的机会来解决。本综述的目的是评估助产护理对剖宫产可能性的影响。方法:检索自记录开始至2020年5月的5个数据库。我们纳入了观察性研究，这些研究报告了助产士参与护理或在医院分娩时剖宫产的优势比或允许计算剖宫产的优势比的数据。标准反方差随机效应荟萃分析用于生成总体优势比(ORs)。结果:我们观察到，在助产士主导的护理、助产士助产、产前接受助产士指导的患者和有助产士在场的机构中，剖宫产的可能性显著降低。结论:在所有的分析中，助产士的护理降低了剖宫产的可能性，可能是由于他们对生理性分娩的更大偏好和技能。在孕产妇保健中增加助产士的使用可以减少剖宫产，应进一步研究和广泛实施，可能作为孕产妇保健的默认方式。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Birth-Issues in Perinatal Care 医学-妇产科学

CiteScore

4.10

自引率

4.00%

发文量

审稿时长

>12 weeks

期刊介绍： Birth: Issues in Perinatal Care is a multidisciplinary, refereed journal devoted to issues and practices in the care of childbearing women, infants, and families. It is written by and for professionals in maternal and neonatal health, nurses, midwives, physicians, public health workers, doulas, social scientists, childbirth educators, lactation counselors, epidemiologists, and other health caregivers and policymakers in perinatal care.