The effect of early skin-to-skin contact on pain and anxiety during episiotomy repair: A systematic review and meta-analysis of randomized controlled trials

IF 2.5 3区医学 Q1 NURSING

Midwifery Pub Date : 2025-05-14 DOI:10.1016/j.midw.2025.104460

Saeed Baradwan , Bandr Hafedh , Khalid Khadawardi , Noor Alanazi , Afnan Baradwan , Yasser Mohamed Said Diab , Bahaa Eldin Elmohamady Mohamed , Mohamed Ali Mohamed , Ateia Ahmad Ateia Abdelaziz , Elsayed Mohammad Taha , Abdullah Gamal Mostafa Mohammed , Albayoumi AB Fouda , Somaia Ragab Eid Mohamed , Ahmed Mohamed Abdelhakim , Mohammed Mamdouh Saleh

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引用次数: 0

Abstract

Objectives

Episiotomy pain contributes to mothers' apprehension about vaginal birth and preference for cesarean sections. Analgesics like lidocaine-related drugs for nerve blockage, as well as sedatives and sleep-inducing medications to alleviate pain and anxiety during episiotomy repair have several side effects. We aimed to investigate the impact of skin-to-skin contact (SCC) on pain and anxiety levels during episiotomy repair.

Methods

We conducted a comprehensive search of four electronic databases (PubMed, Scopus, Cochrane Library, and ISI Web of Science) to identify eligible randomized controlled trials (RCTs) from inception to January 2024. Studies were included if they compared skin-to-skin contact as an intervention during episiotomy repair with a control group that did not receive SSC. A meta-analysis was performed using RevMan software. The primary outcome was pain intensity during and after episiotomy repair, assessed using the 10-cm Visual Analog Scale (VAS). The secondary outcome was anxiety levels during the procedure, measured using the Spielberger State-Trait Anxiety Inventory (STAI) questionnaire. To evaluate the quality of included studies, we used the Cochrane Risk of Bias tool (RoB 1).

Results

Six RCTs, encompassing 833 women, met the inclusion criteria. The results showed that SSC led to a significant decrease in pain scores during and after episiotomy repair (p > 0.001). The anxiety levels during the procedure were also significantly lowered in the SSC group compared to the control group.

Conclusion

Skin-to-skin contact has been demonstrated as an effective method for alleviating pain and anxiety during episiotomy repair.

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早期皮肤接触对会阴切开术修复过程中疼痛和焦虑的影响：随机对照试验的系统回顾和荟萃分析

目的会阴切开术疼痛导致产妇对顺产的恐惧和对剖宫产的偏好。镇痛药，如用于神经阻塞的利多卡因相关药物，以及用于减轻会阴切开术修复过程中的疼痛和焦虑的镇静剂和睡眠诱导药物，都有一些副作用。我们的目的是研究皮肤接触（SCC）对会阴切开术修复过程中疼痛和焦虑水平的影响。方法我们对PubMed、Scopus、Cochrane Library和ISI Web of Science四个电子数据库进行了全面检索，以确定从开始到2024年1月符合条件的随机对照试验（rct）。如果研究将皮肤接触作为会阴切开术修复期间的干预措施与未接受SSC的对照组进行比较，则纳入研究。采用RevMan软件进行meta分析。主要结局是会阴切开术修复期间和之后的疼痛强度，使用10厘米视觉模拟评分（VAS）进行评估。次要结果是手术过程中的焦虑水平，使用Spielberger状态-特质焦虑量表（STAI）问卷进行测量。为了评价纳入研究的质量，我们使用Cochrane偏倚风险工具（RoB 1）。结果6项随机对照试验，833名女性符合纳入标准。结果显示，SSC可显著降低会阴切开术修复期间和修复后的疼痛评分(p >；0.001)。与对照组相比，SSC组在手术过程中的焦虑水平也显著降低。结论皮肤接触是缓解会阴切开术修复过程中疼痛和焦虑的有效方法。

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

Midwifery 医学-护理

CiteScore

4.50

自引率

7.40%

发文量

221

审稿时长

13.4 weeks

期刊介绍： Midwifery publishes the latest peer reviewed international research to inform the safety, quality, outcomes and experiences of pregnancy, birth and maternity care for childbearing women, their babies and families. The journal’s publications support midwives and maternity care providers to explore and develop their knowledge, skills and attitudes informed by best available evidence. Midwifery provides an international, interdisciplinary forum for the publication, dissemination and discussion of advances in evidence, controversies and current research, and promotes continuing education through publication of systematic and other scholarly reviews and updates. Midwifery articles cover the cultural, clinical, psycho-social, sociological, epidemiological, education, managerial, workforce, organizational and technological areas of practice in preconception, maternal and infant care. The journal welcomes the highest quality scholarly research that employs rigorous methodology. Midwifery is a leading international journal in midwifery and maternal health with a current impact factor of 1.861 (© Thomson Reuters Journal Citation Reports 2016) and employs a double-blind peer review process.