International journal of obstetric anesthesia最新文献

英文中文

Airway events in pregnant patients with morbid obesity undergoing caesarean delivery under general anaesthesia: a retrospective cohort study (2015–2024) 妊娠病态肥胖全麻剖宫产患者气道事件的回顾性队列研究（2015-2024）

IF 2.3 3区医学 Q2 ANESTHESIOLOGY

International journal of obstetric anesthesia

Pub Date : 2025-11-08 DOI: 10.1016/j.ijoa.2025.104815

A. Saracoglu , S. Padhy , K.C. Yilmaz , M. Arif , S.R. Kapoor , L. Ramanathan , A. Kumar , K.T. Saracoglu

Background

Airway management in morbidly obese obstetric patients is challenging, with increased risk of difficult ventilation, failed intubation, and maternal morbidity. By focusing exclusively on pregnant patients with a BMI 40 kg/m², this study aimed to quantify the frequency and types of airway complications occurring during cesarean section under general anesthesia, stratified by obesity class. The secondary objective was to identify risk factors for difficult mask ventilation, difficult laryngoscopy, and difficult airway.

Methods

This retrospective cohort study included all 315 pregnant patients aged ≥ 18 years with a BMI ≥ 40 kg/m² who underwent caesarean delivery under general anaesthesia between January 2015 and December 2024. Data on demographics, comorbidities, airway assessments, intubation metrics, and perioperative complications were extracted from electronic medical records. Statistical analyses included correlation testing, group comparisons, and multivariable logistic regression (adjusted for age, BMI, and comorbidties).

Results

A total of 315 patients with morbid obesity were analyzed (Class III: 94.3%; Class IV/V: 5.7%). Overall, the most common airway-related complication was cardiovascular instability (7.9%), followed by laryngospasm (1.6%). When stratified by obesity class, cardiovascular instability was similar in Class III and IV, while other airway complications were generally rare and varied. A positive correlation was observed between BMI and peak airway pressure post-intubation. Thyromental distance inversely correlated with intubation attempts (r = −0.150, P = 0.008) and showed the strongest predictive value (OR 0.22, 95% CI 0.11–0.44; P < 0.001) for difficult mask ventilation. Perioperative complications were infrequent: cardiovascular instability (7.9%) and desaturation < 94% during intubation (1.0%).

Conclusion

In conclusion, cardiovascular instability was the most common airway-related complication, difficult airway incidence increased with obesity class, and thyromental distance was the most consistent predictor, highlighting the need for tailored airway management in obstetric patients with morbid obesity.

背景：病态肥胖产科患者的气道管理具有挑战性，通气困难、插管失败和孕产妇发病率的风险增加。本研究仅针对BMI为40 kg/m2的妊娠患者，旨在量化全麻剖宫产术中气道并发症发生的频率和类型，并按肥胖类别分层。次要目的是确定面罩通气困难、喉镜检查困难和气道困难的危险因素。方法回顾性队列研究纳入2015年1月至2024年12月接受全麻剖宫产的孕妇315例，年龄≥18岁，BMI≥40 kg/m2。统计数据、合并症、气道评估、插管指标和围手术期并发症从电子病历中提取。统计分析包括相关性检验、分组比较和多变量逻辑回归（调整年龄、BMI和合并症）。结果共分析了315例病态肥胖患者，其中III类占94.3%，IV/V类占5.7%。总的来说，最常见的气道相关并发症是心血管不稳定（7.9%），其次是喉痉挛（1.6%）。当按肥胖类别分层时，心血管不稳定性在III类和IV类中相似，而其他气道并发症通常罕见且多样。BMI与插管后气道压力峰值呈正相关。甲状腺距离与插管次数呈负相关（r = - 0.150, P = 0.008），对困难面罩通气的预测价值最强（OR 0.22, 95% CI 0.11-0.44; P < 0.001）。围手术期并发症很少：心血管不稳定（7.9%）和插管期间的去饱和（94%）（1.0%）。结论：心血管不稳定是最常见的气道相关并发症，气道困难发生率随肥胖程度的增加而增加，甲状腺距离是最一致的预测因素，强调了对产科病态肥胖患者进行量身定制气道管理的必要性。

{"title":"Airway events in pregnant patients with morbid obesity undergoing caesarean delivery under general anaesthesia: a retrospective cohort study (2015–2024)","authors":"A. Saracoglu , S. Padhy , K.C. Yilmaz , M. Arif , S.R. Kapoor , L. Ramanathan , A. Kumar , K.T. Saracoglu","doi":"10.1016/j.ijoa.2025.104815","DOIUrl":"10.1016/j.ijoa.2025.104815","url":null,"abstract":"<div><h3>Background</h3><div>Airway management in morbidly obese obstetric patients is challenging, with increased risk of difficult ventilation, failed intubation, and maternal morbidity. By focusing exclusively on pregnant patients with a BMI 40 kg/m<sup>2</sup>, this study aimed to quantify the frequency and types of airway complications occurring during cesarean section under general anesthesia, stratified by obesity class. The secondary objective was to identify risk factors for difficult mask ventilation, difficult laryngoscopy, and difficult airway.</div></div><div><h3>Methods</h3><div>This retrospective cohort study included all 315 pregnant patients aged ≥ 18 years with a BMI ≥ 40 kg/m<sup>2</sup> who underwent caesarean delivery under general anaesthesia between January 2015 and December 2024. Data on demographics, comorbidities, airway assessments, intubation metrics, and perioperative complications were extracted from electronic medical records. Statistical analyses included correlation testing, group comparisons, and multivariable logistic regression (adjusted for age, BMI, and comorbidties).</div></div><div><h3>Results</h3><div>A total of 315 patients with morbid obesity were analyzed (Class III: 94.3%; Class IV/V: 5.7%). Overall, the most common airway-related complication was cardiovascular instability (7.9%), followed by laryngospasm (1.6%). When stratified by obesity class, cardiovascular instability was similar in Class III and IV, while other airway complications were generally rare and varied. A positive correlation was observed between BMI and peak airway pressure post-intubation. Thyromental distance inversely correlated with intubation attempts (r = −0.150, <em>P</em> = 0.008) and showed the strongest predictive value (OR 0.22, 95% CI 0.11–0.44; <em>P</em> < 0.001) for difficult mask ventilation. Perioperative complications were infrequent: cardiovascular instability (7.9%) and desaturation < 94% during intubation (1.0%).</div></div><div><h3>Conclusion</h3><div>In conclusion, cardiovascular instability was the most common airway-related complication, difficult airway incidence increased with obesity class, and thyromental distance was the most consistent predictor, highlighting the need for tailored airway management in obstetric patients with morbid obesity.</div></div>","PeriodicalId":14250,"journal":{"name":"International journal of obstetric anesthesia","volume":"65 ","pages":"Article 104815"},"PeriodicalIF":2.3,"publicationDate":"2025-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145516373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Maternal experience in the intensive care unit and post-discharge care: the third report from the MaCriCare study. 重症监护病房和出院后护理的产妇经验：MaCriCare研究的第三份报告。

IF 2.3 3区医学 Q2 ANESTHESIOLOGY

International journal of obstetric anesthesia

Pub Date : 2025-11-01 Epub Date: 2025-07-22 DOI: 10.1016/j.ijoa.2025.104737

S Cantellow, Ł Balcerzak, A Schyns-van den Berg, D Dabrowska, E Guasch, H Jörnvall, N Lucas, F J Mercier, C F Weiniger, P Krawczyk

Background: Obstetric critical care patients face unique challenges during intensive care unit (ICU) admission, including separation from their newborns and psychological trauma. The ICU environment, primarily designed to support physiological recovery, may not be optimised for maternal experience. Healthcare staff caring for these patients may also experience psychological distress. This is the third report from the MaCriCare study, which examines maternal experiences, follow-up practices, and staff support provisions in ICUs managing obstetric patients across WHO Europe countries.

Methods: Between September 1^st 2021 and January 1^st 2022, a multicentre international survey was conducted and included questions on mother-baby contact, breastfeeding support, single-room availability, psychological screening and follow-up, and psychological support for staff in ICUs serving obstetric units. Data from 928 ICUs were analysed.

Results: Physical contact was facilitated in 64.9% (n=602) of centres, while breastfeeding support was available in 82.2% (n=763). Single-room accommodation was accessible in 50%. Psychological screening for obstetric patients and follow-up were conducted in 30.6% (n=284) and 33.1% (n=307) of centres, respectively. In 61.7% (n=573) of ICUs, psychological support for staff was available following poor maternal outcomes.

Conclusion: While breastfeeding support and some form of mother-baby contact were quite widely available, psychological screening, follow-up, and staff support after poor maternal outcomes remained inconsistent. National-level service mapping is needed to identify best practices and context-specific barriers. The impact of bundled interventions to improve maternal experience during critical illness, and staff support strategies after adverse maternal outcomes, should be formally evaluated in future research.

背景：产科重症监护患者在重症监护病房（ICU）住院期间面临着独特的挑战，包括与新生儿的分离和心理创伤。ICU的环境，主要是为了支持生理恢复，可能不适合产妇的经验。照顾这些病人的医护人员也可能经历心理困扰。这是MaCriCare研究的第三份报告，该研究审查了世卫组织欧洲各国icu管理产科患者的产妇经验、后续做法和工作人员支持规定。方法：在2021年9月1日至2022年1月1日期间，开展了一项多中心国际调查，包括母婴接触、母乳喂养支持、单间可用性、心理筛查和随访以及产科icu工作人员的心理支持等问题。对928例icu的数据进行分析。结果：64.9% （n=602）的中心提供身体接触，82.2% （n=763）的中心提供母乳喂养支持。50%的人可以提供单间住宿。30.6% （n=284）和33.1% （n=307）的中心分别对产科患者进行了心理筛查和随访。在61.7% （n=573）的icu中，工作人员在产妇结局不佳后可获得心理支持。结论：虽然母乳喂养支持和某种形式的母婴接触相当广泛，但不良产妇结局后的心理筛查、随访和工作人员支持仍然不一致。需要进行国家级服务映射，以确定最佳做法和特定于具体情况的障碍。在未来的研究中，应正式评估改善危重疾病期间孕产妇体验的捆绑干预措施的影响，以及不良孕产妇结局后的工作人员支持战略。

{"title":"Maternal experience in the intensive care unit and post-discharge care: the third report from the MaCriCare study.","authors":"S Cantellow, Ł Balcerzak, A Schyns-van den Berg, D Dabrowska, E Guasch, H Jörnvall, N Lucas, F J Mercier, C F Weiniger, P Krawczyk","doi":"10.1016/j.ijoa.2025.104737","DOIUrl":"10.1016/j.ijoa.2025.104737","url":null,"abstract":"<p><strong>Background: </strong>Obstetric critical care patients face unique challenges during intensive care unit (ICU) admission, including separation from their newborns and psychological trauma. The ICU environment, primarily designed to support physiological recovery, may not be optimised for maternal experience. Healthcare staff caring for these patients may also experience psychological distress. This is the third report from the MaCriCare study, which examines maternal experiences, follow-up practices, and staff support provisions in ICUs managing obstetric patients across WHO Europe countries.</p><p><strong>Methods: </strong>Between September 1<sup>st</sup> 2021 and January 1<sup>st</sup> 2022, a multicentre international survey was conducted and included questions on mother-baby contact, breastfeeding support, single-room availability, psychological screening and follow-up, and psychological support for staff in ICUs serving obstetric units. Data from 928 ICUs were analysed.</p><p><strong>Results: </strong>Physical contact was facilitated in 64.9% (n=602) of centres, while breastfeeding support was available in 82.2% (n=763). Single-room accommodation was accessible in 50%. Psychological screening for obstetric patients and follow-up were conducted in 30.6% (n=284) and 33.1% (n=307) of centres, respectively. In 61.7% (n=573) of ICUs, psychological support for staff was available following poor maternal outcomes.</p><p><strong>Conclusion: </strong>While breastfeeding support and some form of mother-baby contact were quite widely available, psychological screening, follow-up, and staff support after poor maternal outcomes remained inconsistent. National-level service mapping is needed to identify best practices and context-specific barriers. The impact of bundled interventions to improve maternal experience during critical illness, and staff support strategies after adverse maternal outcomes, should be formally evaluated in future research.</p>","PeriodicalId":14250,"journal":{"name":"International journal of obstetric anesthesia","volume":"64 ","pages":"104737"},"PeriodicalIF":2.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144812063","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Exploring natural language processing as a tool to improve in obstetric documentation and care. 探索自然语言处理作为工具，以改善产科文件和护理。

IF 2.3 3区医学 Q2 ANESTHESIOLOGY

International journal of obstetric anesthesia

Pub Date : 2025-11-01 Epub Date: 2025-06-30 DOI: 10.1016/j.ijoa.2025.104714

C Sebastian, R A Gabriel, A Sykes, C Cha, B N Burton

引用次数: 0

Chronic pain and long-term disability following postdural puncture headache in obstetric patients: a five-year prospective follow-up of a case-control cohort. 产科患者硬脊膜后穿刺头痛后的慢性疼痛和长期残疾：病例对照队列的5年前瞻性随访。

IF 2.3 3区医学 Q2 ANESTHESIOLOGY

International journal of obstetric anesthesia

Pub Date : 2025-11-01 Epub Date: 2025-08-06 DOI: 10.1016/j.ijoa.2025.104747

A Weiss, A Ioscovich, M Heesen, A Frenkel, D Shatalin, Y Gozal, S Orbach-Zinger, Y Binyamin

Background: Unintended dural puncture is a recognized complication of neuraxial labor analgesia and has been associated with postdural puncture headache (PDPH). While short-term outcomes are well documented, long-term consequences remain poorly characterized. No previous study has reported follow-up beyond two years.

Methods: This prospective case-control study followed 336 women up to five years after delivery. The cohort comprised 113 women who delivered without labor epidural analgesia, 113 women who delivered with uncomplicated labor epidural analgesia, 54 women with PDPH following an unintended dural puncture who were not treated with an epidural blood patch, and 56 women with PDPH following an unintended dural puncture who were treated with an epidural blood patch. Outcomes included the prevalence of chronic headache and backache assessed through standardized telephone questionnaires based on International Classification of Headache Disorders criteria, as well as functional impact over time evaluated using the Von Korff chronic pain grade questionnaire.

Results: At five years, chronic headache was significantly more common in the two PDPH groups (20.4% with an epidural blood patch and 21.4% without) than in the control groups (5.3% with an uncomplicated epidural procedure and 0.9% without labor epidural; P <0.01). Chronic backache showed a similar pattern (20.8% and 16.1% vs. 5.3% and 0.9%, respectively; P <0.01). Most women reported persistent rather than resolving symptoms. Functional impairment increased over time, with high disability reported in 7 of 16 women (43.8%) with PDPH without an epidural blood patch and 4 of 14 women (28.6%) with PDPH with an epidural blood patch, who reported chronic pain at five years.

Conclusions: This five-years follow-up study demonstrates that chronic pain (headache and backache) after an unintended dural puncture is a prolonged condition with substantial functional consequences, challenging its traditional characterization as a transient complication and underscoring the need for long-term follow-up and prevention.

背景：意外硬脊膜穿刺是神经轴分娩镇痛的一种公认的并发症，并与硬脊膜穿刺后头痛（PDPH）有关。虽然短期结果有充分的记录，但长期后果仍不清楚。此前没有研究报告随访超过两年。方法：这项前瞻性病例对照研究对336名妇女进行了随访，随访时间长达5年。该队列包括113名无分娩硬膜外镇痛分娩的妇女，113名无并发症硬膜外镇痛分娩的妇女，54名在意外硬膜穿刺后出现PDPH的妇女，未采用硬膜外血贴治疗，56名在意外硬膜穿刺后出现PDPH的妇女，采用硬膜外血贴治疗。结果包括通过基于国际头痛疾病分类标准的标准化电话问卷评估慢性头痛和背痛的患病率，以及使用Von Korff慢性疼痛分级问卷评估随时间的功能影响。结果：5岁时，慢性头痛在两个PDPH组中（20.4%有硬膜外血贴，21.4%没有）明显高于对照组(5.3%有简单硬膜外手术，0.9%没有硬膜外分娩；结论：这项为期五年的随访研究表明，意外硬脑膜穿刺后的慢性疼痛（头痛和背痛）是一种长期的疾病，具有实质性的功能后果，挑战了其作为一种短暂并发症的传统特征，强调了长期随访和预防的必要性。

{"title":"Chronic pain and long-term disability following postdural puncture headache in obstetric patients: a five-year prospective follow-up of a case-control cohort.","authors":"A Weiss, A Ioscovich, M Heesen, A Frenkel, D Shatalin, Y Gozal, S Orbach-Zinger, Y Binyamin","doi":"10.1016/j.ijoa.2025.104747","DOIUrl":"10.1016/j.ijoa.2025.104747","url":null,"abstract":"<p><strong>Background: </strong>Unintended dural puncture is a recognized complication of neuraxial labor analgesia and has been associated with postdural puncture headache (PDPH). While short-term outcomes are well documented, long-term consequences remain poorly characterized. No previous study has reported follow-up beyond two years.</p><p><strong>Methods: </strong>This prospective case-control study followed 336 women up to five years after delivery. The cohort comprised 113 women who delivered without labor epidural analgesia, 113 women who delivered with uncomplicated labor epidural analgesia, 54 women with PDPH following an unintended dural puncture who were not treated with an epidural blood patch, and 56 women with PDPH following an unintended dural puncture who were treated with an epidural blood patch. Outcomes included the prevalence of chronic headache and backache assessed through standardized telephone questionnaires based on International Classification of Headache Disorders criteria, as well as functional impact over time evaluated using the Von Korff chronic pain grade questionnaire.</p><p><strong>Results: </strong>At five years, chronic headache was significantly more common in the two PDPH groups (20.4% with an epidural blood patch and 21.4% without) than in the control groups (5.3% with an uncomplicated epidural procedure and 0.9% without labor epidural; P <0.01). Chronic backache showed a similar pattern (20.8% and 16.1% vs. 5.3% and 0.9%, respectively; P <0.01). Most women reported persistent rather than resolving symptoms. Functional impairment increased over time, with high disability reported in 7 of 16 women (43.8%) with PDPH without an epidural blood patch and 4 of 14 women (28.6%) with PDPH with an epidural blood patch, who reported chronic pain at five years.</p><p><strong>Conclusions: </strong>This five-years follow-up study demonstrates that chronic pain (headache and backache) after an unintended dural puncture is a prolonged condition with substantial functional consequences, challenging its traditional characterization as a transient complication and underscoring the need for long-term follow-up and prevention.</p>","PeriodicalId":14250,"journal":{"name":"International journal of obstetric anesthesia","volume":"64 ","pages":"104747"},"PeriodicalIF":2.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144799058","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Letter to the Editor: Mothers' experiences of category 1 caesarean delivery under general anaesthesia with the partner present: a prospective explorative study. 致编辑的信：在伴侣在场的情况下，全麻下第一类剖宫产的母亲经历：一项前瞻性探索性研究。

IF 2.3 3区医学 Q2 ANESTHESIOLOGY

International journal of obstetric anesthesia

Pub Date : 2025-11-01 Epub Date: 2025-08-06 DOI: 10.1016/j.ijoa.2025.104746

K Brosnan

引用次数: 0

Postdural puncture headache in obstetrics: revisiting long-term outcomes while reframing risk, consent, and postpartum follow-up 产科硬脊膜穿刺后头痛：重新审视长期结果，同时重新定义风险、同意和产后随访。

IF 2.3 3区医学 Q2 ANESTHESIOLOGY

International journal of obstetric anesthesia

Pub Date : 2025-11-01 DOI: 10.1016/j.ijoa.2025.104813

C. Delgado , L. Leffert

引用次数: 0

Nurse workforce diversity and use of neuraxial labor analgesia in the United States 护士队伍的多样性和使用神经轴分娩镇痛在美国

IF 2.3 3区医学 Q2 ANESTHESIOLOGY

International journal of obstetric anesthesia

Pub Date : 2025-11-01 DOI: 10.1016/j.ijoa.2025.104814

J. Guglielminotti , R. Landau , M. Russell , G. Li

Background

Diversification of the healthcare workforce is promoted to address racial and ethnic disparities in obstetric anesthesia care; however, the supporting evidence remains insufficient. We assessed the association of the nurse workforce diversity with neuraxial labor analgesia (NLA) use and disparities in NLA use.

Methods

We analyzed 2019–2022 US birth certificate data for vaginal and intrapartum cesarean deliveries. The exposure was the registered nurse (RN) diversity index in the hospital county, calculated as the proportion of RNs identifying with minoritized racial and ethnic groups divided by the proportion of the county’s total population identifying with those groups. The index was categorized into quartiles with the first quartile indicating the lowest diversity. The outcome was NLA use. Adjusted odds ratios (aORs) and 95% confidence intervals (CIs) of NLA associated with the diversity index were estimated using mixed-effects logistic regression models.

Results

We analyzed 10,979,988 birth certificates. Overall, 80.0% recorded NLA use. Relative to women who gave birth in hospitals in the first quartile of the RN diversity index (low diversity), the odds of receiving NLA increased 10% for women in the fourth quartile (high diversity) of the index (aOR: 1.10; 95% CI: 1.06, 1.14). Compared with White women, increased odds of receiving NLA associated with higher RN workforce diversity were more pronounced among Hispanic, Black, Asian, American Indian or Alaskan Native, and Native Hawaiian or Other Pacific Islander women.

Conclusions

RN workforce diversity was positively associated with NLA use and reduced disparities in NLA use.

促进医疗保健工作人员的多样化，以解决产科麻醉护理中的种族和民族差异；然而，支持证据仍然不足。我们评估了护士队伍多样性与神经轴分娩镇痛（NLA）使用的关系以及NLA使用的差异。方法分析2019-2022年美国阴道和产宫中剖宫产的出生证明数据。暴露量为医院县注册护士（RN）多样性指数，计算方法为认同少数种族和族裔群体的注册护士比例除以该县总人口认同这些群体的比例。该指数分为四分位数，第一个四分位数表示最低的多样性。结果是NLA的使用。使用混合效应logistic回归模型估计NLA与多样性指数相关的调整优势比（aORs）和95%置信区间（CIs）。结果我们分析了10979988份出生证明。总体而言，80.0%的人使用了NLA。相对于在护士多样性指数的第一个四分位数（低多样性）的医院分娩的妇女，在该指数的第四个四分位数（高多样性）的妇女接受NLA的几率增加了10% （aOR: 1.10; 95% CI: 1.06, 1.14）。与白人女性相比，在西班牙裔、黑人、亚裔、美洲印第安人或阿拉斯加原住民、夏威夷原住民或其他太平洋岛民女性中，接受NLA的几率增加与更高的RN劳动力多样性有关。结论srn员工多样性与NLA使用呈正相关，并降低了NLA使用的差异。

{"title":"Nurse workforce diversity and use of neuraxial labor analgesia in the United States","authors":"J. Guglielminotti , R. Landau , M. Russell , G. Li","doi":"10.1016/j.ijoa.2025.104814","DOIUrl":"10.1016/j.ijoa.2025.104814","url":null,"abstract":"<div><h3>Background</h3><div>Diversification of the healthcare workforce is promoted to address racial and ethnic disparities in obstetric anesthesia care; however, the supporting evidence remains insufficient. We assessed the association of the nurse workforce diversity with neuraxial labor analgesia (NLA) use and disparities in NLA use.</div></div><div><h3>Methods</h3><div>We analyzed 2019–2022 US birth certificate data for vaginal and intrapartum cesarean deliveries. The exposure was the registered nurse (RN) diversity index in the hospital county, calculated as the proportion of RNs identifying with minoritized racial and ethnic groups divided by the proportion of the county’s total population identifying with those groups. The index was categorized into quartiles with the first quartile indicating the lowest diversity. The outcome was NLA use. Adjusted odds ratios (aORs) and 95% confidence intervals (CIs) of NLA associated with the diversity index were estimated using mixed-effects logistic regression models.</div></div><div><h3>Results</h3><div>We analyzed 10,979,988 birth certificates. Overall, 80.0% recorded NLA use. Relative to women who gave birth in hospitals in the first quartile of the RN diversity index (low diversity), the odds of receiving NLA increased 10% for women in the fourth quartile (high diversity) of the index (aOR: 1.10; 95% CI: 1.06, 1.14). Compared with White women, increased odds of receiving NLA associated with higher RN workforce diversity were more pronounced among Hispanic, Black, Asian, American Indian or Alaskan Native, and Native Hawaiian or Other Pacific Islander women.</div></div><div><h3>Conclusions</h3><div>RN workforce diversity was positively associated with NLA use and reduced disparities in NLA use.</div></div>","PeriodicalId":14250,"journal":{"name":"International journal of obstetric anesthesia","volume":"65 ","pages":"Article 104814"},"PeriodicalIF":2.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145462774","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

In Response to "Exploring natural language processing as a tool to improve in obstetric documentation and care." 回应“探索自然语言处理作为改善产科文件和护理的工具”。

IF 2.3 3区医学 Q2 ANESTHESIOLOGY

International journal of obstetric anesthesia

Pub Date : 2025-11-01 Epub Date: 2025-07-17 DOI: 10.1016/j.ijoa.2025.104730

I Ibrahim Hulchafo, J K Scroggins, S E Harkins, H Moen, M Tadiello, K Cato, A Davoudi, D Goffman, J J Aubey, C Green, M Topaz, V Barcelona

引用次数: 0

[Article traduit] L’administration prophylactique d’acide tranexamique chez toutes les femmes enceintes est-elle efficace pour prévenir la survenue d’une hémorragie post-partum? très probablement non. 对所有孕妇预防性使用经氨苄西林酸对预防产后出血有效吗？很可能不会。

IF 2.3 3区医学 Q2 ANESTHESIOLOGY

International journal of obstetric anesthesia

Pub Date : 2025-11-01 Epub Date: 2025-06-23 DOI: 10.1016/j.ijoa.2025.104710

Anne-Sophie Bouthors, Maxence Hureau, Alexander Butwick

引用次数: 0

Response to correspondence from McCarthy et al. regarding maternal sepsis screening and the role of the neutrophil-to-lymphocyte ratio 对McCarthy等人关于母体败血症筛查和中性粒细胞与淋巴细胞比例作用的回复。

IF 2.3 3区医学 Q2 ANESTHESIOLOGY

International journal of obstetric anesthesia

Pub Date : 2025-10-30 DOI: 10.1016/j.ijoa.2025.104804

T. Culling , D. Camilleri , C. Bertorelli , A. Strang , S. Oram , F. Faggian , S. Sharma , A. Ridgway , S. Zaher , M. Labeta , S.A. Jones , L.C. Davies , J. Watkins , K. Siddall , V. Keeping , K. Simpson , M. Bray , P. Ghazal , S.F. Bell , R.E. Collis

引用次数: 0

首页上一页

下一页尾页

类型

全部化学•材料生命科学医学物理工程技术环境•农林材料科学地球科学法学管理学化学环境科学与生态学计算机科学教育学经济学农林科学人文科学生物学数学物理与天体物理心理学综合性期刊其他工业工程理学历史学农学文学信息工程

数据库

全部 ACS Publications Elsevier ieeexplore Springer The Royal Society of Chemistry Wiley

期刊

International journal of obstetric anesthesia

全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.

﹀