Factors affecting womens' attitude towards labor epidural analgesia in a culturally diverse population: a prospective patient-reported outcome study.

IF 2.6 3区医学 Q2 ANESTHESIOLOGY International journal of obstetric anesthesia Pub Date : 2025-01-10 DOI:10.1016/j.ijoa.2025.104329

Raneen Abu Shqara, Gabriela Goldinfeld, Sari Nahir Biderman, Tatiana Sher Brodsky, Asal Darwish, Nadir Ganem, Lior Lowenstein, Maya Frank Wolf

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Abstract

Background: To evaluate pregnant women's intentions to deliver with labor epidural analgesia (LEA) and identify factors influencing decision-making in a diverse population in northern Israel.

Methods: A cross-sectional survey was conducted at Galilee Medical Center from February to July 2024. Women completed pre- and post-labor questionnaires assessing demographics, religiosity, prior experience, prenatal education, attitude towards LEA, reasons for not intending to deliver with and actual LEA use. Statistical analysis included multivariate logistic regression.

Results: The LEA rate among participants was 83.5% (380/455) (83.5%); 257 (56.5%) had indented to deliver with. Among those not intending to deliver with LEA, 66.7% (132/198) eventually delivered with. There were 297 (65.3%) Arab and 158 (34.7%) Jewish women; 180 (39.6%) identified as Muslim, 158 (34.7%) Jewish, 92 (20.2%) Druze, and 25 (5.5%) Christian. Factors associated with intention to deliver with LEA were nulliparity (P =0.024), childbirth preparation course (P =0.002), internet as source of information (P =0.016), and previous delivery with LEA (P <0.001). Factors associated with not intending to deliver with but ultimately delivering with LEA were nulliparity (P =0.033), partner presence (P <0.001), labor induction (P =0.044), and previous delivery with LEA (P <0.001).

Conclusion: Attitudes toward LEA are shaped by culture, knowledge, prior experiences, and social support. In our cohort, the most important factors for delivering with LEA when not intending to were previous delivery with LEA and partner presence. Factors associated with not delivering with LEA were preference for natural childbirth and fear of LEA-associated side effects. Promoting evidence-based information through language-adapted platforms can further improve informed decision-making about LEA.

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影响不同文化人群中妇女对分娩硬膜外镇痛态度的因素：一项前瞻性患者报告的结果研究

背景：在以色列北部不同人群中评估孕妇使用硬膜外镇痛（LEA）分娩的意向，并确定影响决策的因素。方法：于2024年2月至7月在加利利医疗中心进行横断面调查。妇女完成了产前和产后问卷调查，评估人口统计、宗教信仰、先前经验、产前教育、对LEA的态度、不打算使用LEA分娩的原因和实际使用LEA。统计分析采用多元逻辑回归。结果：受试者LEA率为83.5% (380/455)；257人（56.5%）有凹痕。在不打算使用LEA分娩的患者中，66.7%（132/198）最终使用LEA分娩。其中阿拉伯女性297人（65.3%），犹太女性158人（34.7%）；180人（39.6%）为穆斯林，158人（34.7%）为犹太人，92人（20.2%）为德鲁兹派，25人（5.5%）为基督徒。未产（P =0.024）、分娩准备过程（P =0.002）、网络信息来源（P =0.016）、曾产(P)与预备分娩意愿相关。结论：预备分娩态度受文化、知识、经验和社会支持的影响。在我们的队列中，当不打算用LEA分娩时，最重要的因素是以前用LEA分娩和合作伙伴在场。不采用LEA分娩的相关因素是倾向于自然分娩和担心LEA相关的副作用。通过适应语言的平台推广基于证据的信息，可以进一步改善LEA的知情决策。

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来源期刊

International journal of obstetric anesthesia 医学-妇产科学

CiteScore

4.70

自引率

7.10%

发文量

285

审稿时长

58 days

期刊介绍： The International Journal of Obstetric Anesthesia is the only journal publishing original articles devoted exclusively to obstetric anesthesia and bringing together all three of its principal components; anesthesia care for operative delivery and the perioperative period, pain relief in labour and care of the critically ill obstetric patient. • Original research (both clinical and laboratory), short reports and case reports will be considered. • The journal also publishes invited review articles and debates on topical and controversial subjects in the area of obstetric anesthesia. • Articles on related topics such as perinatal physiology and pharmacology and all subjects of importance to obstetric anaesthetists/anesthesiologists are also welcome. The journal is peer-reviewed by international experts. Scholarship is stressed to include the focus on discovery, application of knowledge across fields, and informing the medical community. Through the peer-review process, we hope to attest to the quality of scholarships and guide the Journal to extend and transform knowledge in this important and expanding area.