Midwifery最新文献_第9页

Prevalence and determinants of fear of childbirth among pregnant women in Egypt: A cross-sectional study 埃及孕妇分娩恐惧的普遍性和决定因素：一项横断面研究。

IF 2.6 3区医学 Q1 NURSING

Midwifery

Pub Date : 2024-07-02 DOI: 10.1016/j.midw.2024.104088

Nadia Bassuoni Elsharkawy , Majed Mowanes Alruwaili , Osama Mohamed Elsayed Ramadan , Abeer Nuwayfi Alruwaili , Marwa Mohamed Ahmed Ouda , Fatma Ali Oraby , Azza Medhat Aziz Mansy , Enas Mahrous Abdelaziz

Problem

Fear of childbirth (FOC) is a significant public health concern, and understanding its determinants is crucial for developing effective interventions to support women during pregnancy and childbirth.

Background

Fear of childbirth (FOC) is increasingly recognized as an essential psychological health concern among pregnant women globally. However, research elucidating the prevalence and multifaceted determinants of FOC in the Egyptian context remains scarce. This knowledge is pivotal to informing maternal health practices.

Aim

This study aimed to investigate FOC prevalence and its determinants among pregnant women in Egypt.

Methods

A cross-sectional study was conducted among 460 low-risk pregnant women attending antenatal clinics in El-Beheira Governorate, Egypt, from February 2023 to July 2023. Data were collected using structured questionnaires on sociodemographic and obstetric profiles, the Childbirth Attitude Questionnaire, the Childbirth Self-Efficacy Inventory, and the Multidimensional Scale of Perceived Social Support.

Results

The prevalence of FOC ranged from mild to severe, with 70.4% of women displaying some degree of fear and 11.3% exhibiting severe FOC. Key determinants associated with greater FOC were younger age, nulliparity, unplanned pregnancy, negative previous birth experiences, and preference for cesarean delivery. An inverse relationship was found between FOC and childbirth self-efficacy.

Conclusions

This study reveals a high FOC prevalence among Egyptian pregnant women, necessitating the need for systematic screening and tailored interventions to mitigate this concern, especially among high-risk groups like young, nulliparous mothers. Fostering childbirth self-efficacy may aid in reducing FOC. These findings can inform the enhancement of holistic maternal health practices in Egypt.

问题：分娩恐惧（FOC）是一个重要的公共健康问题，了解其决定因素对于制定有效的干预措施以支持孕期和分娩妇女至关重要：背景：分娩恐惧（FOC）越来越被认为是全球孕妇的一个重要心理健康问题。然而，在埃及，阐明分娩恐惧的普遍性和多方面决定因素的研究仍然很少。目的：本研究旨在调查 FOC 在埃及孕妇中的流行情况及其决定因素：这项横断面研究于 2023 年 2 月至 2023 年 7 月在埃及贝希拉省的产前诊所对 460 名低风险孕妇进行了调查。研究采用结构化问卷收集数据，问卷内容包括社会人口学和产科概况、分娩态度问卷、分娩自我效能量表和感知社会支持多维量表：分娩恐惧的发生率从轻微到严重不等，70.4%的产妇表现出某种程度的恐惧，11.3%的产妇表现出严重的分娩恐惧。年龄较小、无排卵、计划外怀孕、以往负面的分娩经历以及倾向于剖腹产是导致 FOC 增加的主要决定因素。FOC 与分娩自我效能之间呈反比关系：这项研究揭示了埃及孕妇的顺产率很高，因此有必要进行系统筛查并采取有针对性的干预措施来减轻这一问题，尤其是在年轻、无产科的母亲等高危人群中。培养分娩自我效能感可能有助于减少无痛分娩。这些研究结果可为埃及加强孕产妇综合保健实践提供参考。

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引用次数: 0

“If it has happened once, it can happen again”. The impact of previous pregnancy loss on anxious women's ongoing pregnancies: A qualitative study from Pakistan "如果它发生过一次，就可能再次发生"。前一次怀孕失败对焦虑妇女正在进行的怀孕的影响：巴基斯坦的一项定性研究

IF 2.6 3区医学 Q1 NURSING

Midwifery

Pub Date : 2024-06-28 DOI: 10.1016/j.midw.2024.104087

Hadia Maryam , Rakhshanda Liaqat , Armaan A Rowther , Maria Atiq , Huma Nazir , Abid Malik , Atif Rahman , Pamela J Surkan , Najia Atif

Background

Pregnancy loss that includes both miscarriage and stillbirth cause significant psychological distress for women including anxiety, depression, and grief that persist long after physical recovery. This study focuses on the experiences of women in Pakistan, where pregnancy loss rates are high.

Objective

To explore how pregnant women with anxiety symptoms and a history of pregnancy loss perceive their past experiences with the loss and how it affects overall well-being in their current pregnancy.

Design

Qualitative methods were used to explore the impact of previous pregnancy loss on the well-being of pregnant women.

Setting

This qualitative research was embedded within a randomized control trial conducted in a tertiary care facility in Rawalpindi, Pakistan.

Participants

Data were collected through in-depth interviews with 18 pregnant women who had experienced pregnancy loss. Data was analyzed using Framework Analysis.

Findings

The findings revealed several factors influencing participants' well-being during pregnancies that resulted in a loss, such as unsupportive and abusive environments, unintended pregnancies, certain superstitious beliefs, poor health, and lack of access to quality healthcare. The study also highlighted the adverse impact of previous pregnancy loss on the ongoing pregnancy, including deterioration of physical and mental health and aversion of healthcare services. However, some participants reported positive changes in medical and self-care practices and an enhanced faith and reliance on destiny in their subsequent pregnancies.

Conclusion

Our study highlights the lasting impact of past pregnancy loss on subsequent pregnancies, affecting overall wellbeing and leading to healthcare avoidance. We identified persistent anxiety along with positive outcomes like enhanced medical practices and strengthened faith. Results suggest the need for culturally responsive interventions to support the overall well-being of anxious pregnant women with a history of pregnancy loss in resource-constrained settings.

背景包括流产和死胎在内的妊娠损失会给妇女造成严重的心理困扰，包括焦虑、抑郁和悲伤，这些情绪在身体恢复后仍会长期存在。本研究关注的是巴基斯坦妇女的经历，那里的妊娠损失率很高.Objective To explore how pregnant women with anxiety symptoms and a history of pregnancy loss perceive their past experiences with the loss and how it affects overall well-being in their current pregnancy.DesignQualitative methods were used to explore the impact of previous pregnancy loss on the well-being of pregnant women.SettingThis qualitative research was embedded within a randomized control trial conducted in a tertiary care facility in Rawalpindi, Pakistan.Participants数据是通过对 18 名经历过妊娠损失的孕妇进行深入访谈收集的。研究结果研究结果表明，在导致流产的妊娠期间，有几个因素影响着参与者的健康，如不支持和虐待性的环境、意外怀孕、某些迷信信仰、健康状况差以及无法获得高质量的医疗保健服务。研究还强调了之前的妊娠失败对正在进行的妊娠的不利影响，包括身心健康恶化和厌恶医疗保健服务。然而，一些参与者报告说，她们在医疗和自我护理方面发生了积极的变化，并在随后的怀孕过程中增强了对命运的信心和依赖。我们在发现持续焦虑的同时，也发现了一些积极的结果，如加强了医疗实践和增强了信仰。研究结果表明，在资源有限的环境中，需要采取符合文化特点的干预措施，以支持有过失孕史的焦虑孕妇的整体健康。

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引用次数: 0

International News August 八月国际新闻

IF 2.6 3区医学 Q1 NURSING

Midwifery

Pub Date : 2024-06-27 DOI: 10.1016/j.midw.2024.104074

引用次数: 0

Differing intensities of a midwife-led antenatal healthy lifestyle service on maternal and neonatal outcomes: A retrospective cohort study 助产士主导的产前健康生活方式服务对产妇和新生儿预后的不同影响：回顾性队列研究

IF 2.6 3区医学 Q1 NURSING

Midwifery

Pub Date : 2024-06-26 DOI: 10.1016/j.midw.2024.104078

Frankie J Fair, Hora Soltani

Introduction

Maternal obesity and excessive gestational weight gain are associated with adverse maternal and neonatal outcomes. There is uncertainty over the most effective antenatal healthy lifestyle service, with little research determining the impact of different lifestyle intervention intensities on pregnancy outcomes.

Method

This retrospective cohort study compared pregnancy and birth outcomes in women with a body mass index of 40 or above who were offered a low intensity midwife-led antenatal healthy lifestyle service (one visit) with women who were offered an enhanced service (three visits). The primary outcome was gestational weight gain.

Results

There were no differences between the two healthy lifestyle service intensities (N = 682) in the primary outcome of mean gestational weight gain [adjusted mean difference (aMD) -1.1 kg (95 % CI -2.3 to 0.1)]. Women offered the enhanced service had lower odds of gaining weight in excess of Institute of Medicine recommendations [adjusted odds ratio (aOR) 0.63 (95 % CI 0.40–0.98)] with this reduction mainly evident in multiparous women. Multiparous women also gained less weight per week [aMD -0.06 kg/week (95 % CI -0.11 to -0.01)]. No overall beneficial effects were seen in maternal or neonatal outcomes measured such as birth weight [aMD 25 g (95 % CI -71 to 121)], vaginal birth [aOR 0.87 (95 % CI 0.64–1.19)] or gestational diabetes mellitus [aOR 1.42 (95 % CI 0.93–2.17)]. However, multiparous women receiving the enhanced service had reduced odds of small for gestational age [aOR 0.52 (95 % CI 0.31–0.87)]. This study was however underpowered to detect differences in some outcomes with low incidences.

Discussion

Uncertainty remains over the best management of women with severe obesity regarding effective interventions in terms of intensity. It is suggested that further research needs to consider the different classes of obesity separately and have a particular focus on the needs of nulliparous women given the lack of effectiveness of this service among these women.

孕产妇肥胖和妊娠期体重增加过多与孕产妇和新生儿的不良预后有关。最有效的产前健康生活方式服务尚不确定，很少有研究确定不同生活方式干预强度对妊娠结局的影响。这项回顾性队列研究比较了体重指数在 40 或以上、接受助产士指导的低强度产前健康生活方式服务（一次就诊）和接受强化服务（三次就诊）的妇女的妊娠和分娩结局。主要结果是妊娠体重增加。两种健康生活方式服务强度（= 682）在妊娠体重平均增长这一主要结果上没有差异[调整后平均差异（aMD）-1.1 千克（95 % CI -2.3-0.1）]。接受强化服务的妇女体重增加超过医学研究所建议值的几率较低[调整后的几率比（aOR）为 0.63 (95 % CI 0.40-0.98)]，这种降低主要体现在多产妇身上。多产妇每周体重增加也较少[aMD -0.06 kg/周（95 % CI -0.11--0.01）]。在出生体重[aMD 25 g (95 % CI -71 to 121)]、阴道分娩[aOR 0.87 (95 % CI 0.64-1.19)]或妊娠期糖尿病[aOR 1.42 (95 % CI 0.93-2.17)]等孕产妇或新生儿预后方面，未发现总体的有益影响。然而，接受强化服务的多胎妊娠妇女出现小于胎龄的几率降低[aOR 0.52 (95 % CI 0.31-0.87)]。不过，这项研究的力量不足，无法检测到一些发病率较低的结果的差异。对于重度肥胖妇女的最佳管理，在有效干预强度方面仍存在不确定性。建议进一步的研究需要分别考虑不同类型的肥胖症，并特别关注无子宫妇女的需求，因为这项服务在这些妇女中缺乏有效性。

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引用次数: 0

Women's experience of adopting lateral positions during the second stage of labour compared with conventional lithotomy positions: A cross-sectional study 产妇在第二产程中采用侧卧位与传统平卧位的比较：横断面研究。

IF 2.6 3区医学 Q1 NURSING

Midwifery

Pub Date : 2024-06-26 DOI: 10.1016/j.midw.2024.104077

Jing Huang , Yu Zang , Minghui Yang , Jianying Wang , Yinchu Hu , Xue Feng , Lihua Ren , Hong Lu

Aims

Maternal positions during childbirth play an important role in safe vaginal births and might also influence women's childbirth experiences greatly. Lateral positions, as a potential position to reduce negative maternal and neonatal outcomes, have become popular in recent years, especially in China where the adoption of conventional lithotomy positions is still common. However, the childbirth experience of those who gave birth in lateral positions has been rarely studied. This study aimed to describe and compare women's childbirth experiences of adopting the newly introduced lateral positions and the conventional lithotomy positions during the second stage of labour.

Study design

A cross-sectional study was conducted in two tertiary hospitals in China involving a total of 658 primiparous and parous women who adopted lateral and lithotomy positions during the second stage of labour from July to November 2020. Sociodemographic characteristics, maternal and neonatal outcomes as well as childbirth experience assessed by the Childbirth Experience Questionnaire (CEQ) were collected. This study followed the STROBE guidelines.

Results

Women who once adopted lateral positions during the second stage of labour had better positive childbirth experiences compared with those in the lithotomy positions group, as demonstrated by their overall higher CEQ scores. Women in the lateral position group also reported better participation and perceived safety, and a greater sense of control during childbirth. Lateral positions remained an influential factor in CEQ scores after controlling for potential confounders. In this study, adverse maternal and neonatal outcomes were rare. Women in lateral positions had comparatively better perineal outcomes.

Conclusion

This study described and compared women's childbirth experiences of adopting conventional lithotomy positions and lateral positions during the second stage of labour using a valid instrument. Women who adopted lateral positions during the second stage of labour reported better childbirth experiences than those giving birth in the conventional lithotomy positions. Thus, assisting women in giving birth in lateral positions might be a promising way to improve women's childbirth experience.

目的：分娩时的产妇体位在阴道安全分娩中起着重要作用，同时也可能极大地影响产妇的分娩体验。侧卧位作为一种可能减少产妇和新生儿不良结局的体位，近年来开始流行起来，尤其是在中国，采用传统的平卧位仍然很普遍。然而，很少有人研究过采用侧卧位分娩的产妇的分娩经历。本研究旨在描述和比较产妇在第二产程中采用新引入的侧卧位和传统碎石位的分娩体验：研究设计：在中国两家三级医院进行了一项横断面研究，共涉及 658 名初产妇和准妈妈，她们在 2020 年 7 月至 11 月的第二产程中采用了侧卧位和碎石位。研究收集了社会人口学特征、孕产妇和新生儿结局以及通过分娩体验问卷（CEQ）评估的分娩体验。这项研究遵循了 STROBE 指南：结果：在第二产程中采用侧卧位的产妇与采用平卧位的产妇相比，有更好的积极分娩体验，这体现在她们的 CEQ 总分更高。侧卧位组的产妇还表示，她们在分娩过程中的参与度和安全感更高，控制感更强。在控制了潜在的混杂因素后，侧卧位仍是影响CEQ评分的一个因素。在这项研究中，孕产妇和新生儿的不良结局并不多见。侧卧位产妇的会阴结果相对较好：本研究使用有效的工具描述并比较了产妇在第二产程中采用传统平卧位和侧卧位的分娩体验。在第二产程中采用侧卧位分娩的产妇比采用传统切开术分娩的产妇有更好的分娩体验。因此，帮助产妇采用侧卧位分娩可能是改善产妇分娩体验的一种有前途的方法。

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引用次数: 0

Midwifery continuity of care, breastfeeding and neonatal hyperbilirubinemia: A retrospective cohort study 助产士持续护理、母乳喂养和新生儿高胆红素血症：一项回顾性队列研究。

IF 2.6 3区医学 Q1 NURSING

Midwifery

Pub Date : 2024-06-26 DOI: 10.1016/j.midw.2024.104079

Mahshid Abdi Shahshahani , Xingrong Liu , Mikael Norman , Ellen L. Tilden , Mia Ahlberg

Aim

To examine the association between Midwifery Continuity of Care (MCoC) and exclusive breastfeeding at hospital discharge and neonatal hyperbilirubinemia.

Methods

A matched cohort design was employed using data from the Swedish Pregnancy Register. The study included 12,096 women who gave birth at a university hospital in Stockholm, Sweden from January 2019 to August 2021. Women and newborns cared for in a MCoC model were compared with a propensity-score matched set receiving standard care. Risk ratios (RR) were determined with 95 % confidence intervals (CI) based on the matched cohort through modified Poisson regressions with robust standard error. A mediation analysis assessed the direct and indirect effects of MCoC on exclusive breastfeeding at hospital discharge and neonatal hyperbilirubinemia and to what extent the association was mediated by preterm birth.

Finding

Findings showed that MCoC was associated with a higher chance of exclusive breastfeeding rate (RR: 1.06, 95 % CI: 1.01–1.12) and lower risk of neonatal hyperbilirubinemia (RR: 0.51, 95 % CI: 0.32–0.82) compared with standard care. Mediation analysis demonstrated that lower preterm birth accounted for approximately 28 % of total effect on the reduced risk of neonatal hyperbilirubinemia.

Discussion/Conclusion

This matched cohort study provided preliminary evidence that MCoC models could be an intervention for improving exclusive breastfeeding rates at hospital discharge and reducing the risk of neonatal hyperbilirubinemia.

目的：研究助产士持续护理（MCoC）与出院时纯母乳喂养和新生儿高胆红素血症之间的关系：利用瑞典妊娠登记册的数据，采用匹配队列设计。研究对象包括 2019 年 1 月至 2021 年 8 月期间在瑞典斯德哥尔摩一家大学医院分娩的 12096 名妇女。在 MCoC 模式下接受护理的妇女和新生儿与接受标准护理的倾向分数匹配组进行了比较。在匹配队列的基础上，通过带稳健标准误差的修正泊松回归确定了风险比 (RR)，并得出了 95% 的置信区间 (CI)。一项中介分析评估了 MCoC 对出院时纯母乳喂养和新生儿高胆红素血症的直接和间接影响，以及早产对这种关联的中介作用：研究结果表明，与标准护理相比，MCoC与更高的纯母乳喂养率（RR：1.06，95 % CI：1.01-1.12）和更低的新生儿高胆红素血症风险（RR：0.51，95 % CI：0.32-0.82）相关。中介分析表明，较低的早产率约占降低新生儿高胆红素血症风险总效应的 28%：这项匹配队列研究提供了初步证据，证明 MCoC 模型可作为一种干预措施，提高出院时的纯母乳喂养率，降低新生儿高胆红素血症的风险。

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引用次数: 0

Partner and professional support are associated with father-infant bonding: A cross-sectional analysis of mothers, midwives, and child health nurses’ influence on primiparous and multiparous fathers of infants in Sweden 伴侣和专业人员的支持与父婴关系的建立有关：瑞典母亲、助产士和儿童保健护士对初产和多产婴儿父亲影响的横断面分析。

IF 2.6 3区医学 Q1 NURSING

Midwifery

Pub Date : 2024-06-24 DOI: 10.1016/j.midw.2024.104076

Michael B. Wells , Michele Giannotti , Olov Aronson

Objective

To assess if received professional and social support are associated with father-infant bonding among primiparous (first-time) and multiparous (multi-time) fathers.

Background

Early father-infant bonding predicts several positive child outcomes. However, while received professional and social support positively impacts fathers’ transition into parenthood, little research has tested if these factors are associated with a stronger father-infant bond.

Methods

In total, 499 fathers (296 primiparous and 203 multiparous) of infants (aged 0–12 months) completed a cross-sectional online survey between November 2018 and March 2020. The survey included items related to socio-demographics, having a planned pregnancy, postnatal midwifery support, child health nurse support, child health center attendance, and social support. The parent-infant bonding questionnaire (PBQ) was used to assess the father-infant bond. Multiple linear regression models were estimated for the total sample and based on paternal parity. Missing data were managed through multiple imputation procedures.

Findings

Fathers reported fewer bonding disturbances if they received support from their partners, postnatal midwives, child health nurses, and attended more child health visits. Primiparous fathers reported fewer bonding disturbances when receiving support from their partners, postnatal midwives, and the child health nurse. However, multiparous fathers had more bonding disturbances than primiparous fathers and received less professional and partner support.

Conclusions

Receiving more partner and professional support is associated with less father-infant bonding disturbances. To encourage a better father-infant bond, clinicians should invite and support all fathers, regardless of parity, as they transition to parenthood.

目的：评估初产父亲（第一次当父亲）和多产父亲（多次当父亲）所获得的专业支持和社会支持是否与父婴关系有关：评估初产父亲（第一次当父亲）和多产父亲（多次当父亲）所获得的专业和社会支持是否与父婴关系有关：背景：早期的父婴亲子关系可预测儿童的若干积极结果。然而，虽然获得专业和社会支持对父亲向为人父母的过渡有积极影响，但很少有研究检验这些因素是否与加强父婴关系有关：2018年11月至2020年3月期间，共有499名婴儿（0-12个月大）的父亲（296名初产妇和203名多胎妊娠者）完成了一项横断面在线调查。调查内容包括与社会人口统计学、是否计划怀孕、产后助产支持、儿童保健护士支持、儿童保健中心就诊情况和社会支持相关的项目。亲子关系问卷（PBQ）用于评估父婴关系。对全部样本和基于父亲奇偶性的多元线性回归模型进行了估计。缺失数据通过多重估算程序处理：如果父亲得到其伴侣、产后助产士和儿童保健护士的支持，并参加更多的儿童健康检查，那么他们报告的亲子关系障碍就会减少。初产父亲如果得到伴侣、产后助产士和儿童保健护士的支持，则会减少亲子关系障碍。然而，与初产父亲相比，多胎父亲的亲情障碍更多，获得的专业和伴侣支持也更少：结论：获得更多的伴侣和专业支持与较少的父婴联系障碍有关。为了鼓励建立更好的父婴关系，临床医生应邀请并支持所有父亲，无论其胎次如何，帮助他们向为人父母过渡。

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引用次数: 0

Rural-urban and racial differences in cesarean deliveries before and during the COVID-19 pandemic in South Carolina 南卡罗来纳州 COVID-19 大流行之前和期间剖宫产率的城乡和种族差异。

IF 2.6 3区医学 Q1 NURSING

Midwifery

Pub Date : 2024-06-21 DOI: 10.1016/j.midw.2024.104075

Cassie L. Odahowski , Peiyin Hung , Berry A. Campbell , Jihong Liu , Nansi S. Boghossian , Anirban Chatterjee , Yiwen Shih , Chelsea Norregaard , Bo Cai , Xiaoming Li

Problem

Unnecessary cesarean delivery increases the risk of complications for birthing people and infants.

Background

Examining the intersectionality of rural and racial disparities in low-risk cesarean delivery is necessary to improve equity in quality obstetrics care.

Aim

To evaluate rural and racial/ethnic differences in Nulliparous, Term, Singleton, Vertex (NTSV) and primary cesarean delivery rates before and during the COVID-19 pandemic in South Carolina.

Methods

This retrospective cohort study used birth certificates linked to all-payer hospital discharge data for South Carolina childbirths from 2018 to 2021. Multilevel logistic regressions examined differences in cesarean outcomes by rural/urban hospital location and race/ethnicity of birthing people during pre-pandemic (January 2018–February 2020) and peri-pandemic periods (March 2020–December 2021), adjusting for maternal, infant, and hospital characteristics among two low-risk pregnancy cohorts: 1) Nulliparous, Term, Singleton, Vertex (NTSV, n = 65,974) and 2) those without prior cesarean (primary, n = 167,928).

Findings

Black vs. White disparities remained for NTSV cesarean in adjusted models (urban pre-pandemic aOR = 1.34, 95 %CI 1.23–1.46) but were not significantly different for primary cesarean, apart from rural settings peri-pandemic (aOR = 0.87, 95 %CI 0.79–0.96). Hispanic individuals had higher adjusted odds of NTSV cesarean only for rural settings pre-pandemic (aOR = 1.28, 95 %CI 1.05–1.56), but this disparity was not significant during the pandemic (aOR = 1.13, 95 %CI 0.93–1.37).

Discussion and conclusion

Observed rural and racial/ethnic disparities in cesarean delivery outcomes were present before and during the COVID-19 pandemic. Strategies effective in reducing racial disparities in primary cesarean may be useful in also reducing Black vs. White NTSV cesarean disparities.

问题：不必要的剖宫产会增加分娩者和婴儿出现并发症的风险：目的：评估南卡罗来纳州COVID-19大流行之前和期间无子宫、足月、单胎、顶体（NTSV）和初次剖宫产率的农村和种族/族裔差异：这项回顾性队列研究使用的出生证明与南卡罗来纳州 2018 年至 2021 年所有付费者医院出院数据相关联。多层次逻辑回归研究了大流行前（2018 年 1 月至 2020 年 2 月）和大流行期间（2020 年 3 月至 2021 年 12 月）按农村/城市医院地点和分娩者种族/民族划分的剖宫产结果差异，并对两个低风险妊娠队列中的产妇、婴儿和医院特征进行了调整：1) 无子宫、足月、单胎、顶点（NTSV，n = 65974）和 2) 无剖宫产史（primary，n = 167928）：在调整后的模型中，黑人与白人在 NTSV 剖宫产方面仍存在差异（大流行前的城市 aOR = 1.34，95 %CI 1.23-1.46），但除了大流行前的农村环境（aOR = 0.87，95 %CI 0.79-0.96）外，在初次剖宫产方面没有显著差异。只有在大流行前的农村地区，西班牙裔的 NTSV 剖宫产调整后几率更高（aOR = 1.28，95 %CI 1.05-1.56），但在大流行期间，这一差异并不显著（aOR = 1.13，95 %CI 0.93-1.37）：讨论与结论：在 COVID-19 大流行之前和期间，在剖宫产结果方面观察到的农村和种族/民族差异是存在的。减少初次剖宫产种族差异的有效策略可能也有助于减少黑人与白人 NTSV 剖宫产的差异。

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引用次数: 0

The experience of pregnant women and their families who were infected with covid-19 before vaccination: Comment 接种疫苗前感染 covid-19 的孕妇及其家人的经历：评论。

IF 2.6 3区医学 Q1 NURSING

Midwifery

Pub Date : 2024-06-21 DOI: 10.1016/j.midw.2024.104069

引用次数: 0

The Stirling Antenatal Anxiety Scale (SAAS): Turkish validity and reliability study 斯特林产前焦虑量表（SAAS）：土耳其有效性和可靠性研究。

IF 2.6 3区医学 Q1 NURSING

Midwifery

Pub Date : 2024-06-20 DOI: 10.1016/j.midw.2024.104073

Elif Zahide Çelebi , Elif Tozkır , Gülsen Çayır , Merve Murat , Nezihe Kızılkaya Beji , Nilgün Avcı , Andrea Sinesi

Aims

To examine the psychometric properties of the Stirling Antenatal Anxiety Scale (SAAS), developed by Sinesi et al., which assesses the level of anxiety of pregnant women in the prenatal period, in the Turkish culture, and to conduct a validity and reliability study.

Methods

This study had a methodological approach, with a cross-sectional and descriptive research design. Reporting was in accordance with the STROBE checklist. The sample included 160 pregnant women who were followed up in the maternity outpatient clinics of a public hospital and a private hospital in Istanbul. Data were collected face-to-face using a personal information form, the Turkish version of the SAAS, and the Generalized Anxiety Disorder-7 scale between June and August 2023. In the data analysis, validity analyses were performed with content and construct validity and multiple fit indices for confirmatory factor analysis. Item-total score analysis was conducted using Cronbach's alpha coefficient and Pearson's correlation analysis to assess reliability. Descriptive and reliability analyses were undertaken using SPSS v.28.0.1.0, and validity analyses were performed using SPSS AMOS v.26.0.0.0.

Findings

Based on expert opinions on the items in the Turkish version of the SAAS, the content validity ratio was 0.96. The decision was made to exclude Item 9 from the Turkish version because the item factor load was low. The Turkish version had a single factor, as did the original version. The Cronbach alpha coefficient was 0.87, so the Turkish version was determined to have high reliability.

Conclusion

The Turkish version of the SAAS, originally produced in English, has high levels of validity and reliability. In addition, it is short and easy to apply in clinical and research settings. As such, the Turkish version of the SAAS is recommended for use to evaluate the level of anxiety in pregnant women.

目的：研究由 Sinesi 等人开发的斯特林产前焦虑量表（SAAS）在土耳其文化中的心理测量特性，该量表用于评估产前孕妇的焦虑程度，并进行有效性和可靠性研究：本研究采用横断面和描述性研究设计的方法。根据 STROBE 检查表进行报告。样本包括伊斯坦布尔一家公立医院和一家私立医院产科门诊随访的 160 名孕妇。研究人员在2023年6月至8月期间使用个人信息表、土耳其版SAAS和广泛性焦虑症-7量表面对面收集数据。在数据分析中，进行了内容效度和结构效度的有效性分析，以及确认性因素分析的多重拟合指数。项目总分分析采用克朗巴赫α系数和皮尔逊相关分析来评估信度。使用 SPSS v.28.0.1.0 进行了描述性分析和信度分析，使用 SPSS AMOS v.26.0.0.0 进行了效度分析：根据专家对土耳其版 SAAS 项目的意见，内容效度比为 0.96。由于土耳其版的项目因子载荷较低，因此决定将项目 9 从土耳其版中剔除。与原始版本一样，土耳其版本也只有一个因子。Cronbach alpha 系数为 0.87，因此确定土耳其版本具有较高的可靠性：土耳其语版的 SAAS 最初是用英语编制的，具有较高的有效性和可靠性。结论：SAAS 的土耳其语版本最初是用英语编写的，具有较高的效度和信度，而且简短，易于在临床和研究环境中应用。因此，建议使用土耳其版 SAAS 评估孕妇的焦虑程度。

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