Fear of Childbirth After Major Orthopedic Traumas: A Nationwide Multi-Register Analysis.

IF 2.8 3区医学 Q1 NURSING

Birth-Issues in Perinatal Care Pub Date : 2024-08-30 DOI:10.1111/birt.12869

Matias Vaajala, Rasmus Liukkonen, Ilari Kuitunen, Ville Ponkilainen, Ville M Mattila, Maiju Kekki

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引用次数: 0

Abstract

Background: The aim of this study was to evaluate the association between previous major traumas and the prevalence of fear of childbirth (FOC) and the subsequent effects of FOC on the intended mode of delivery.

Methods: In this nationwide retrospective register-based cohort study, data from the Care Register for Health Care were linked with the National Medical Birth Register (MBR) to evaluate the prevalence of FOC after major traumas. A total of 18,573 pregnancies met the inclusion criteria. A multivariable logistic regression model was used to assess the effects of FOC on the intended mode of delivery. Women with major traumas before pregnancy were compared to individuals with wrist fractures. Adjusted odds ratios (aORs) with 95% CIs between the groups were compared.

Results: Of those pregnancies that occurred after major traumas, 785 (6.2%) women were diagnosed with FOC after traumatic brain injury (TBI), 111 (6.1%) women after spine fracture, 38 (5.0%) women after pelvic fracture, 22 (3.2%) women after hip or thigh fracture, and 399 (5.2%) women in the control group. Among those women diagnosed with FOC, the adjusted odds for elective CB as an intended mode of delivery were highest among women with previous spine fractures (aOR 2.28, CI 1.45-3.60) when compared to the control group.

Conclusions: We found no evidence of differences in maternal FOC in patients with preceding major traumas when compared to the control group. Therefore, it seems highly likely that the major trauma itself is the explanatory factor for the increased rate of elective CB.

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重大骨科创伤后对分娩的恐惧：一项全国性多登记分析。

研究背景本研究旨在评估先前的重大创伤与分娩恐惧（FOC）发生率之间的关联，以及分娩恐惧对预定分娩方式的后续影响：在这项以登记为基础的全国性回顾性队列研究中，医疗保健登记处的数据与国家出生医学登记处（MBR）的数据进行了连接，以评估重大创伤后分娩恐惧的发生率。共有 18,573 例妊娠符合纳入标准。采用多变量逻辑回归模型评估了FOC对预定分娩方式的影响。将孕前受过重大创伤的妇女与腕部骨折的妇女进行比较。比较了各组之间的调整后几率比（aOR）和 95% CI：在重大创伤后怀孕的妇女中，785 名（6.2%）妇女在创伤性脑损伤（TBI）后被诊断为 FOC，111 名（6.1%）妇女在脊柱骨折后被诊断为 FOC，38 名（5.0%）妇女在骨盆骨折后被诊断为 FOC，22 名（3.2%）妇女在髋部或大腿骨折后被诊断为 FOC，对照组中的妇女为 399 名（5.2%）。与对照组相比，在确诊为难产的产妇中，曾发生过脊柱骨折的产妇选择 CB 作为预定分娩方式的调整后几率最高（aOR 2.28，CI 1.45-3.60）：与对照组相比，我们没有发现证据表明曾有重大创伤的患者在产妇无痛分娩方面存在差异。因此，重大创伤本身极有可能是导致择期 CB 发生率增加的原因。

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.