Relationships Among Mode of Birth, Onset of Labor, and Bishop Score

IF 1.8 4区医学 Q2 NURSING Jognn-Journal of Obstetric Gynecologic and Neonatal Nursing Pub Date : 2024-09-01 DOI:10.1016/j.jogn.2024.04.002

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Abstract

Objective

To investigate mode of birth in relation to onset of labor and Bishop score.

Design

Retrospective observational cohort design.

Setting

A 434-bed Magnet redesignated community hospital.

Participants

Nulliparous women, 18 years of age or older, who gave birth at 37 to 41 weeks gestation to live, singleton fetuses in the vertex presentation (N = 701).

Methods

We conducted a retrospective chart review and used chi-square analysis to measure the associations among mode of birth, onset of labor, and Bishop score. We used logistic regression to test the probability of cesarean birth for women undergoing elective induction of labor.

Results

Most participants (n = 531, 75.7%) gave birth vaginally. Significant findings included the following relationships: spontaneous onset of labor and vaginal birth (χ² = 22.2, Ø = 0.18, p < .001) and Bishop score of greater than or equal to 8 and vaginal birth (χ² = 4.9, Ø = .14, p = .028). Induction of labor was a significant predictor in cesarean birth when controlling for age and body mass index (OR = 2.1, 95% confidence interval [1.5, 3.1], p < .001).

Conclusion

Reducing elective induction of labor in women with low-risk pregnancies may help lower the risk of cesarean birth. Clinically, Bishop score and mode of birth have a weak association, particularly when induction includes cervical ripening.

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分娩方式、分娩开始时间和 Bishop 评分之间的关系。

摘要研究分娩方式与开始分娩和主教评分的关系：设计：回顾性观察队列设计：一家拥有 434 张床位的 Magnet e 级社区医院：年龄在 18 岁或以上、在妊娠 37 至 41 周分娩的无阴道产妇，其分娩方式为活产、单胎头位（N = 701）：我们对病历进行了回顾性分析，并使用卡方分析法测量了分娩方式、分娩开始时间和 Bishop 评分之间的关联。我们使用逻辑回归法检测了接受选择性引产的产妇剖宫产的概率：大多数参与者（n = 531，75.7%）经阴道分娩。重要发现包括以下关系：自然分娩与阴道分娩（χ2 = 22.2，Ø = 0.18，p < .001）；Bishop评分大于或等于8与阴道分娩（χ2 = 4.9，Ø = .14，p = .028）。在控制年龄和体重指数的情况下，引产对剖宫产有显著的预测作用（OR = 2.1，95% 置信区间 [1.5，3.1]，p < .01）：结论：减少低危妊娠妇女的选择性引产可能有助于降低剖宫产风险。在临床上，毕夏普评分与分娩方式的关系不大，尤其是当引产包括宫颈成熟时。

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来源期刊

Jognn-Journal of Obstetric Gynecologic and Neonatal Nursing 医学-妇产科学

CiteScore

3.20

自引率

5.60%

发文量

审稿时长

43 days

期刊介绍： JOGNN is a premier resource for health care professionals committed to clinical scholarship that advances the health care of women and newborns. With a focus on nursing practice, JOGNN addresses the latest research, practice issues, policies, opinions, and trends in the care of women, childbearing families, and newborns. This peer-reviewed scientific and technical journal is highly respected for groundbreaking articles on important - and sometimes controversial - issues. Articles published in JOGNN emphasize research evidence and clinical practice, building both science and clinical applications. JOGNN seeks clinical, policy and research manuscripts on the evidence supporting current best practice as well as developing or emerging practice trends. A balance of quantitative and qualitative research with an emphasis on biobehavioral outcome studies and intervention trials is desired. Manuscripts are welcomed on all subjects focused on the care of women, childbearing families, and newborns.