Sexual & Reproductive Healthcare最新文献

Maternal outcomes among women with type 1 diabetes in Sweden. A population-based cohort study 瑞典1型糖尿病妇女的孕产结局一项基于人群的队列研究

IF 1.7 3区医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Sexual & Reproductive Healthcare

Pub Date : 2026-01-27 DOI: 10.1016/j.srhc.2026.101193

Alexandra Goldberg , Eva Wiberg-Itzel , Joanna Tingström , Cecilia Ekéus

Objective

Type 1 diabetes (T1D) increases the risk of pregnancy complications due to hyperglycemia and vasculopathy, leading to higher rates of preeclampsia and obstetric interventions. A contemporary reassessment of maternal and obstetric outcomes in women with T1D is needed, considering care for women with T1D in Sweden is inequitable. This study aimed to investigate maternal and obstetric outcomes among women with T1D in Sweden.

Methods

In this population-based cohort study, data from the Swedish Medical Birth Register were used to compare maternal and obstetric outcomes among women with and without T1D. The study included all primiparous women with singleton births beyond 22 + 0 gestational weeks and a planned vaginal delivery between 2010 and 2022 (N = 558 546). Logistic regression analyses were performed, and results are presented as adjusted odds ratios (aORs) with 95% confidence intervals (CIs).

Results

Among the study population, 2749 women had T1D and 555 797 did not. After adjustment, women with T1D had increased odds of preeclampsia (aOR 5.57; 95% CI 5.07–6.16), induction of labor (aOR 6.62; 95% CI 6.11–7.18), cesarean section (aOR 4.71; 95% CI 4.35–5.11), and shoulder dystocia (aOR 11.81; 95% CI 9.20–15.17). Elevated risks were also observed for vacuum extraction, prolonged labor, fetal distress, and postpartum endometritis.

Conclusions

Women with T1D face substantially higher risks of pregnancy complications and birth interventions compared with women without T1D. These findings underscore the importance of tailored preconception and perinatal care, as well as targeted interventions to improve maternal and obstetric outcomes in T1D.

目的1型糖尿病（T1D）由于高血糖和血管病变而增加妊娠并发症的风险，导致子痫前期和产科干预的发生率更高。考虑到瑞典对T1D妇女的护理不公平，有必要对T1D妇女的孕产妇和产科结果进行当代重新评估。本研究旨在调查瑞典T1D妇女的产妇和产科结局。方法在这项以人群为基础的队列研究中，使用瑞典医疗出生登记处的数据来比较有和没有T1D的妇女的产妇和产科结局。该研究包括所有在2010年至2022年期间生育超过22 + 0孕周且计划阴道分娩的单胎妇女（N = 558 546）。进行逻辑回归分析，结果以校正优势比（aORs）和95%置信区间（CIs）表示。结果在研究人群中，2749名女性患有T1D， 555797名女性没有。调整后，T1D患者发生先兆子痫（aOR 5.57; 95% CI 5.07-6.16）、引产（aOR 6.62; 95% CI 6.11-7.18）、剖宫产（aOR 4.71; 95% CI 4.35-5.11）和肩难产（aOR 11.81; 95% CI 9.20-15.17）的几率增加。真空抽吸、长时间分娩、胎儿窘迫和产后子宫内膜炎也会增加风险。结论与非T1D妇女相比，T1D妇女妊娠并发症和分娩干预的风险明显更高。这些发现强调了量身定制的孕前和围产期护理的重要性，以及有针对性的干预措施，以改善T1D的孕产妇和产科结局。

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引用次数: 0

Women’s satisfaction and experiences with water birth compared with conventional birth 妇女对水中分娩与常规分娩的满意度与体验

IF 1.7 3区医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Sexual & Reproductive Healthcare

Pub Date : 2026-01-26 DOI: 10.1016/j.srhc.2026.101190

Elina Hummel , Maria Nordin , Natalie Safrani , Magdalena Elfving , Matilda Alton , Sahruh Turkmen

Objective

To compare women’s experience and satisfaction with water birth versus conventional birth.

Methods

We conducted a prospective cohort study of 132 low-risk pregnant women in Västernorrland County, Sweden (Nov 2022–Apr 2025), including 75 water births and 57 conventional vaginal births. Eligibility required spontaneous or induced labour, singleton pregnancies in cephalic presentation, and Swedish language proficiency. Background variables (maternal age, BMI, parity, gestational age, education) were recorded. Maternal and neonatal outcomes were obtained from medical records, while satisfaction with care during birth was measured using a visual analog scale (VAS) and childbirth experience was assessed using the Childbirth Experience Questionnaire (CEQ). Group comparisons and clinically relevant differences were analyzed.

Results

The demographic characteristics of the two groups did not differ significantly. Women in the water birth group reported higher total CEQ scores (14.7 vs. 14.1, P = 0.002), particularly in the domains of Own Capacity (3.25 vs. 2.88, P < 0.001) and Perceived Safety (3.83 vs. 3.67, P = 0.02). They also reported significantly higher VAS scores (10 vs. 9, P = 0.03). However, after adjusting for potential confounders, no significant associations were found between water birth and the CEQ domains or VAS scores. Additionally, there were no significant differences in adverse maternal or neonatal outcomes, including postpartum bleeding, perineal tears, Apgar scores, cord blood gas analyses, or neonatal intensive care unit admissions.

Conclusions

Water birth showed higher satisfaction and experience scores than conventional birth, though not directly attributable to the method. Similar clinical outcomes suggest it is a safe alternative for appropriately selected low-risk women.

目的比较水中分娩与常规分娩对产妇分娩的体验和满意度。方法对瑞典Västernorrland县132例低危孕妇（2022年11月- 2025年4月）进行前瞻性队列研究，其中75例为水中分娩，57例为常规顺产。入选条件为自然分娩或引产，头位单胎妊娠，熟练掌握瑞典语。记录背景变量（产妇年龄、体重指数、胎次、胎龄、教育程度）。从医疗记录中获得孕产妇和新生儿结局，同时使用视觉模拟量表（VAS）测量分娩过程中的护理满意度，使用分娩经验问卷（CEQ）评估分娩经验。分析组间比较及临床相关差异。结果两组患者人口学特征无显著差异。水中分娩组的妇女报告了更高的CEQ总分（14.7比14.1,P = 0.002），特别是在自身能力（3.25比2.88,P < 0.001）和感知安全（3.83比3.67,P = 0.02）领域。他们也报告了更高的VAS评分（10比9，P = 0.03）。然而，在调整了潜在的混杂因素后，没有发现水中分娩与CEQ域或VAS评分之间存在显著关联。此外，在产妇或新生儿的不良结局方面，包括产后出血、会阴撕裂、Apgar评分、脐带血气体分析或新生儿重症监护病房入院情况，没有显著差异。结论水中分娩的满意度和体验得分高于常规分娩，但与分娩方式没有直接关系。类似的临床结果表明，对于适当选择的低风险妇女，这是一种安全的选择。

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引用次数: 0

Barriers and facilitators to engage with the maternity continuum of care in northwest Ethiopia: a qualitative descriptive study 障碍和促进参与产妇护理的连续性在埃塞俄比亚西北部：定性描述性研究

IF 1.7 3区医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Sexual & Reproductive Healthcare

Pub Date : 2026-01-23 DOI: 10.1016/j.srhc.2026.101187

Birye Dessalegn Mekonnen , Vidanka Vasilevski , Ayele Geleto Bali , Linda Sweet

Aim

Globally, women’s engagement with the maternity continuum of care throughout pregnancy, childbirth, and the postpartum period helps reduce maternal and newborn deaths. However, women’s engagement with the maternity continuum of care remains low in Ethiopia, and the underlying reasons are not yet well understood. This study aimed to explore the facilitators and barriers influencing women’s engagement with the maternity continuum of care in northwest Ethiopia.

Methods

A qualitative descriptive approach was employed. Fifteen postpartum women and six healthcare workers were purposively selected and interviewed to gather diverse perspectives. Following consent, interviews were audio recorded, transcribed in Amharic, and then translated into English. Data were analysed using Braun and Clarke’s reflexive thematic analysis using NVivo 15.

Findings

Key barriers to engaging with the maternity continuum of care included limited awareness and low health literacy, difficulties in accessing and receiving care, lack of social and community support, and restrictive cultural and traditional practices. Facilitators included having awareness of maternity care and understanding of maternity care benefits, improved access to maternity services, strong support from family and social networks, and the availability of community health initiatives.

Conclusions

Multiple barriers affect women’s engagement with the maternity continuum of care. Interventions such as health education should focus on increasing awareness among women and communities about the maternity continuum of care, supporting women, and promoting positive changes within cultural norms and traditions. Strong commitment from both government and healthcare providers is essential to improve service accessibility and ensure respectful maternity care.

在全球范围内，妇女在整个怀孕、分娩和产后期间接受连续的产妇护理有助于减少孕产妇和新生儿死亡。然而，在埃塞俄比亚，妇女参与产妇连续护理的程度仍然很低，其根本原因尚未得到很好的了解。本研究旨在探讨促进因素和障碍，影响妇女参与产妇护理的连续性在埃塞俄比亚西北部。方法采用定性描述方法。有目的地选择15名产后妇女和6名保健工作者进行访谈，以收集不同的观点。在获得同意后，采访录音，用阿姆哈拉语转录，然后翻译成英语。数据分析使用Braun和Clarke的反身性专题分析，使用NVivo 15。开展产妇连续护理的主要障碍包括认识有限和卫生知识水平低、难以获得和接受护理、缺乏社会和社区支持以及限制性的文化和传统习俗。促进因素包括对产妇护理的认识和对产妇护理福利的了解、改善获得产妇服务的机会、家庭和社会网络的大力支持以及社区保健倡议的可用性。结论多重障碍影响妇女参与产妇连续护理。保健教育等干预措施应侧重于提高妇女和社区对产妇连续护理的认识，支持妇女，并促进文化规范和传统中的积极变化。政府和医疗保健提供者的坚定承诺对于改善服务可及性和确保尊重产妇护理至关重要。

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引用次数: 0

Postpartum work ability among women with severe perineal trauma at childbirth: An exploratory cross-sectional pilot study in Sweden 分娩时严重会阴创伤妇女的产后工作能力：瑞典的一项探索性横断面试点研究

IF 1.7 3区医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Sexual & Reproductive Healthcare

Pub Date : 2026-01-22 DOI: 10.1016/j.srhc.2026.101188

Katharina Tjernström , Henrik Holmberg , Kristina Edvardsson , Christine Murray , Inger Lindberg , Maria Wiklund , Margareta Persson

Objective

Existing literature offers fragmented insights into working life following severe perineal trauma (SPT), suggesting positive and negative implications. No research has systematically examined work ability or potential risk factors associated with impaired work ability. This study assessed and compared work ability among women with SPT more than 18 months postpartum and identified potential risk factors for impaired work ability.

Methods

An exploratory cross-sectional pilot study was conducted in Sweden. Participants were recruited via digital platforms (n = 197) and included women who sustained SPT during childbirth more than 18 months before data collection. Data were collected via an online questionnaire and analysed using multivariable logistic regression.

Results

Nearly one-third of participants reported impaired work ability. Absence of reconstructive surgery, increased life impact of pelvic floor disorders, and history of sick leave in adult life were identified as risk factors for impaired work ability.

Conclusions

The complexity of health problems following SPT may affect women’s ability to work. Given the exploratory nature and limited sample size of this pilot study, larger longitudinal studies – using national registers or multicentre recruitment – are needed to confirm the observed associations and deepen understanding of the multifaceted consequences of health problems following SPT.

目的：现有文献对严重会阴创伤（SPT）后的工作生活提供了零散的见解，提出了积极和消极的影响。没有研究系统地检查工作能力或与工作能力受损相关的潜在风险因素。本研究评估并比较了产后18个月以上SPT妇女的工作能力，并确定了工作能力受损的潜在危险因素。方法：在瑞典进行了一项探索性的横断面试点研究。参与者通过数字平台招募（n = 197），包括在数据收集前18个月在分娩期间持续SPT的妇女。通过在线问卷收集数据，并使用多变量逻辑回归进行分析。结果：近三分之一的参与者报告工作能力受损。缺乏重建手术，骨盆底疾病对生活的影响增加，以及成年后的病假史被确定为工作能力受损的危险因素。结论：SPT后健康问题的复杂性可能影响妇女的工作能力。鉴于该试点研究的探索性和有限的样本量，需要进行更大规模的纵向研究——使用国家登记或多中心招募——以确认观察到的关联，并加深对SPT后健康问题的多方面后果的理解。

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引用次数: 0

Women’s experiences of massage during childbearing: A Swedish qualitative interview study 妇女在生育期间按摩的经验：瑞典定性访谈研究

IF 1.7 3区医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Sexual & Reproductive Healthcare

Pub Date : 2026-01-22 DOI: 10.1016/j.srhc.2026.101186

Amanda Claesson Karhunen , Maria Henricson , Rajna Knez , Caroline Bäckström

Objective

Massage during childbearing has been shown to benefit women’s health and well-being, such as reducing pain and stress and enhancing satisfaction with the labour experience. Despite these documented benefits, massage is not routinely offered as a complementary method by midwives within standard maternity care in Sweden, leaving women’s lived experiences of massage in this context unexplored. Therefore, this study aimed to explore women’s experiences of massage during childbearing.

Methods

The research was conducted as a qualitative study using an inductive approach. Semi-structured interviews with 12 women in Sweden were carried out, and data were analysed using qualitative content analysis.

Results

Analysis of the data yielded one overall theme—seen, heard and touched—and three categories: being mentally present in the body, a vulnerability needed to be respected and sharing experiences. Massage promoted present-moment awareness, trust and safety and relieved pain and stress. It also strengthened the connection with one’s own body and deepened closeness to both partner and unborn child. However, it was associated with vulnerability and the recall of bodily memories.

Conclusion

Massage during childbearing is a supportive practice that integrates physical and emotional well-being with mental recovery, making women feel seen, heard and touched. For optimal benefits and positive experiences, massage must be provided with respect to boundaries. This is particularly important because it may evoke sensitive memories, which involve a vulnerability that needs to be respected. Massage is a valuable complementary method alongside maternity care.

目的研究表明，在分娩期间进行按摩有益于妇女的健康和福祉，如减轻疼痛和压力，提高对分娩体验的满意度。尽管有这些文献记载的好处，但在瑞典，助产士在标准的产科护理中并没有常规地将按摩作为一种补充方法，这使得女性在这种情况下的按摩生活经历未被探索。因此，本研究旨在探讨女性在生育期间的按摩体验。方法采用归纳法进行定性研究。对瑞典的12名妇女进行了半结构化访谈，并使用定性内容分析对数据进行了分析。对数据的分析得出了一个总体主题——看到、听到和触摸——以及三个类别：精神上存在于身体中、需要被尊重的弱点和分享经验。按摩促进当下意识，信任和安全，缓解疼痛和压力。它还加强了与自己身体的联系，加深了与伴侣和未出生的孩子的亲密关系。然而，它与脆弱和身体记忆的回忆有关。结论孕期按摩是一种将身心健康与精神康复相结合的支持性实践，能让女性感受到被关注、被倾听、被触动。为了获得最佳的好处和积极的体验，按摩必须提供尊重边界。这一点尤其重要，因为它可能会唤起敏感的记忆，这涉及到一个需要被尊重的弱点。按摩是一个有价值的补充方法与产妇护理。

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引用次数: 0

Sexual and reproductive health outcomes and parent-child communication among youth in western Kenya 肯尼亚西部青少年的性健康和生殖健康成果及亲子交流。

IF 1.7 3区医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Sexual & Reproductive Healthcare

Pub Date : 2026-01-21 DOI: 10.1016/j.srhc.2025.101179

Sylvia Ayieko , Nema C.M. Aluku , Abigail A. Lee , William T. Story

Purpose

The high rates of adolescent pregnancy in Kenya are due, in part, to the lack of discussions about sexual and reproductive health (SRH) between children and their parents/guardians. The aim of this study was to assess the association between parent–child communication and SRH outcomes among youth in western Kenya.

Methods

Cross-sectional data was collected in September 2022 from 1,598 youth (ages 15–24) who completed a survey about parent- child communication and SRH behaviors. Using descriptive statistics and logistic regressions, we assessed the association between parent–child communication and three SRH outcomes: intention to abstain from sex, use of family planning methods, and consistent condom use.

Results

Results showed that the intention to abstain from sex was high among all study participants (65 %). Among those with prior sexual experience, the use of family planning methods was high (68 %), while consistent condom use was low (39 %). Parent-child communication about SRH was low, with a mean score of 5.5 out of 14. Findings indicated significant positive associations between parent–child communication and intention to abstain for at least one year (AOR= 1.07; 95 % CI: 1.05–1.10), and consistent condom use (AOR = 1.08; 95 % CI: 1.03–1.12), although the use family planning methods among females was not statistically significant.

Discussion

Parents do not frequently discuss sexual topics with their children. While there were differences in rates of intention to abstain by gender, parent–child communication was significant. There is a need to equip parents and youth with SRH discussion skills to improve SRH outcomes among adolescents.

目的：肯尼亚少女怀孕率高，部分原因是儿童与其父母/监护人之间缺乏关于性健康和生殖健康的讨论。本研究的目的是评估亲子沟通与肯尼亚西部青少年性生殖健康结果之间的关系。方法：于2022年9月对1598名15-24岁青少年进行了亲子沟通和性生殖健康行为调查。使用描述性统计和逻辑回归，我们评估了亲子沟通与三个SRH结果之间的关系：放弃性行为的意图、使用计划生育方法和持续使用避孕套。结果：结果显示，所有研究参与者中禁欲的意愿都很高（65%）。在有过性经历的人群中，计划生育方法的使用率很高（68%），而一贯使用避孕套的比例很低（39%）。家长与孩子关于性生殖健康的沟通较低，平均得分为5.5分（总分14分）。研究结果显示，尽管在女性中使用计划生育方法的情况没有统计学意义，但亲子沟通与禁欲意愿至少一年（AOR= 1.07; 95% CI: 1.05-1.10）和持续使用安全套（AOR= 1.08; 95% CI: 1.03-1.12）之间存在显著正相关。讨论：父母不会经常和孩子讨论性的话题。尽管性别在戒酒意愿率上存在差异，但亲子沟通是显著的。有必要让父母和青少年掌握性健康与生殖健康的讨论技巧，以改善青少年性健康与生殖健康的结果。

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引用次数: 0

Birth interventions and outcomes among first time mothers: A population-based register study in four Nordic countries 第一次母亲的出生干预和结果：在四个北欧国家进行的一项基于人口的登记研究

IF 1.7 3区医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Sexual & Reproductive Healthcare

Pub Date : 2026-01-18 DOI: 10.1016/j.srhc.2026.101185

Emma Swift , Charlotte Elvander , Ellen Blix , Mika Gissler , Tiina Murto , Rikke Damkjær Maimburg , Rebecka Dalbye , Helga Gottfreðsdóttir , Kamilla Groenemeijer Nielsen , Hanna Ulfsdottir , Eva Rydahl

Introduction

Although the Nordic countries generally report lower caesarean section rates compared with middle- and high-income settings, caesarean section represents only one dimension of obstetric intervention. Limited evidence exists regarding the prevalence of physiological birth across the Nordic region. We aimed to describe and compare cross-country variations in intrapartum intervention rates and birth-related complications among nulliparous women in Finland, Iceland, Norway, and Sweden.

Methods

This Nordic observational study used data from the Finnish, Icelandic, Norwegian, and Swedish Medical Birth Registers for all nulliparous births in 2020. Three composite outcomes described levels of obstetric intervention and complications: (1) births without major interventions or complications, (2) births without interventions or complications (may include epidural/spinal analgesia), and (3) physiological births without complications. Prevalence was calculated for each outcome and logistic regression used to estimate odds ratios and 95% confidence intervals.

Results

Prevalence of births without major interventions or complications differed between countries and were most common in Sweden (62.4%; 95%CI:64.0–64.9) and least common in Finland (45.0%; 95%CI:44.3–45.7). Births without interventions and complications was most common in Iceland (29.4%; 95%CI:27.4–31.5) and least common in Finland (15.9%; 95%CI:15.4–16.4). Physiological births without complications were most common in Iceland (19.1%; 95%CI:17.4–20.0) and least common in Finland (6.1%; 95%CI:5.8–6.5).

Conclusion

Overall, about one in eight primiparous women in four Nordic countries experienced a physiological birth without complications. This finding invites reflection on how maternity care systems, professional practices, and cultural attitudes toward birth may shape opportunities for women to experience childbirth as a normal physiological process.

虽然北欧国家报告的剖宫产率普遍低于中、高收入国家，但剖宫产只是产科干预的一个方面。关于生理出生在北欧地区的普遍存在的证据有限。我们的目的是描述和比较芬兰、冰岛、挪威和瑞典的未分娩妇女的产时干预率和分娩相关并发症的跨国差异。方法：这项北欧观察性研究使用了芬兰、冰岛、挪威和瑞典医学出生登记处2020年所有无产新生儿的数据。三个复合结局描述了产科干预和并发症的水平：(1)无重大干预或并发症的分娩，(2)无干预或并发症（可能包括硬膜外/脊髓镇痛）的分娩，以及(3)无并发症的生理分娩。计算每个结果的患病率，并使用逻辑回归来估计优势比和95%置信区间。结果无重大干预措施或并发症的出生患病率在各国之间存在差异，瑞典最常见（62.4%;95%CI:64.0 ~ 64.9），芬兰最不常见（45.0%;95%CI:44.3 ~ 45.7）。无干预和并发症的分娩在冰岛最常见（29.4%;95%CI: 27.4-31.5），在芬兰最不常见（15.9%;95%CI: 15.4-16.4）。无并发症的生理性分娩在冰岛最常见（19.1%;95%CI: 17.4-20.0），在芬兰最不常见（6.1%;95%CI: 5.8-6.5）。总的来说，在四个北欧国家，大约八分之一的初产妇经历了无并发症的生理分娩。这一发现引起了人们对产科护理系统、专业实践和对分娩的文化态度如何影响妇女将分娩作为正常生理过程的机会的反思。

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引用次数: 0

Outcomes of labor induction in primiparous women with unfavorable cervical status at gestational week 41 and beyond. Does the Bishop score matter? 妊娠41周及以上宫颈状况不良的初产妇引产的结果。毕晓普的得分重要吗？

IF 1.7 3区医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Sexual & Reproductive Healthcare

Pub Date : 2026-01-14 DOI: 10.1016/j.srhc.2026.101183

Ragnheidur Rósa Ólafsdóttir , Anna Eckerdal Toll , Maria Jonsson , Cecilia Ekéus

Objectives: In Sweden, induction practices have shifted, and since 2020, national guidelines recommend induction of labor (IOL) at 41 gestational weeks. This study aimed to examine mode of delivery, childbirth experience and breastfeeding initiation among primiparous undergoing IOL at gestational week ≥41+0 with a Bishop score (BS) of 0–5.

Material and methods: This cohort study was based on prospectively collected data from medical records of 348 healthy primiparous with singleton pregnancies who underwent IOL at ≥ 41 + 0 weeks of gestation with a BS of 0–5. Outcomes included mode of delivery, childbirth experience, and breastfeeding. Women were divided into two categories according to their cervical status: very unfavorable score (BS 0–3) and moderately unfavorable score (BS 4–5). Outcomes were compared using descriptive statistics and logistic regression, with odds ratios (OR) and 95% confidence intervals (CI).

Results: Emergency cesarean section (CS) was significantly more frequent among women with BS 0–3 compared to BS 4–5 (23% vs. 11%; OR 2.58, 95% CI 1.30–5.11). A negative childbirth experience (VAS < 5) was reported twice as often in the BS 0–3 group (20% vs. 10%; OR 2.08, 95% CI 1.03–4.20). No significant differences were found in the initiation of breastfeeding.

Conclusions.

Induction of labor in healthy primiparous with a BS of 0–3 at or beyond 41 weeks is associated with an increased risk of emergency cesarean section and negative childbirth experience. These findings underscore the clinical importance of various degrees of cervical ripeness before induction.

目的：在瑞典，引产实践发生了变化，自2020年以来，国家指南推荐在妊娠41周引产（IOL）。本研究旨在探讨≥41+0孕周接受IOL的初产妇的分娩方式、分娩经历和母乳喂养开始情况，Bishop评分（BS）为0 - 5。材料和方法：本队列研究基于前瞻性收集的348例健康单胎妊娠孕妇的病历资料，这些孕妇在妊娠≥41 + 0周时接受了人工晶状体植入，BS为0 - 5。结果包括分娩方式、分娩经历和母乳喂养。根据妇女的宫颈状况分为两类：非常不利评分（BS 0-3）和中等不利评分（BS 4-5）。结果采用描述性统计和逻辑回归进行比较，采用优势比（OR）和95%置信区间（CI）。结果：与BS 4-5相比，BS 0-3的妇女急诊剖宫产（CS）的发生率明显更高（23%对11%；OR 2.58, 95% CI 1.30-5.11）。BS 0-3组报告不良分娩经历（VAS < 5）的频率是对照组的两倍（20% vs. 10%; OR 2.08, 95% CI 1.03-4.20）。结论：41周及以上BS值为0-3的健康初产妇引产与急诊剖宫产和不良分娩经历的风险增加有关。这些发现强调了引产前不同程度宫颈成熟的临床重要性。

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引用次数: 0

Demographic differentials in births assisted by trained midwives in Nineteenth-Century Sweden: What difference did it make for infant survival? 19世纪瑞典由训练有素的助产士接生的人口统计学差异：对婴儿存活率有何影响？

IF 1.7 3区医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Sexual & Reproductive Healthcare

Pub Date : 2025-12-28 DOI: 10.1016/j.srhc.2025.101181

Lena Karlsson

Objectives

This study examines the influence of social and demographic factors on the utilization of trained midwives in Sweden during the latter half of the nineteenth century. It also examines differences in neonatal, post-neonatal, and child mortality between births attended by trained midwives and those without such assistance.

Methods

The analysis is based on population data covering 116,597 births. Logistic regression models were used to estimate the association between midwifery, background characteristics, and mortality outcomes.

Results

The findings reveal substantial regional variation in the use of trained midwives throughout the study period. Births attended by trained midwives were more common among high-risk births and among married women compared to unmarried women. Regarding mortality, the results show an increased risk of post-neonatal mortality during the first period (1860–1869), and a decreased risk of neonatal mortality during the final period (1890–1894).

Conclusion

The study highlights the evolving role of trained midwives in childbirth practices in 19th-century Sweden and their contribution to reducing infant mortality, which coincided with the introduction of antiseptic methods from 1880 onward.

目的：本研究考察了社会和人口因素对19世纪下半叶瑞典受过培训的助产士的利用的影响。它还审查了由训练有素的助产士接生和没有这种帮助的助产士接生之间新生儿、新生儿后期和儿童死亡率的差异。方法：基于116,597例出生人口数据进行分析。使用逻辑回归模型来估计助产、背景特征和死亡率结果之间的关系。结果：研究结果显示，在整个研究期间，训练有素的助产士的使用存在实质性的区域差异。与未婚妇女相比，由受过训练的助产士接生在高危分娩和已婚妇女中更为常见。关于死亡率，研究结果表明，在第一阶段（1860-1869年）新生儿后期死亡率风险增加，而在最后阶段（1890-1894年）新生儿死亡率风险降低。结论：该研究强调了19世纪瑞典训练有素的助产士在分娩实践中不断发展的作用，以及她们对降低婴儿死亡率的贡献，这与1880年以后引入的消毒方法相吻合。

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引用次数: 0

Impact of COVID-19 on Group B Streptococcus Colonization Prevalence And Pregnancy Outcomes: A Single-Center Retrospective Study COVID-19对B族链球菌定植流行率和妊娠结局的影响：一项单中心回顾性研究

IF 1.7 3区医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Sexual & Reproductive Healthcare

Pub Date : 2025-12-28 DOI: 10.1016/j.srhc.2025.101182

Shuang Wang , Roksana Behruzi , Muhammad Ramzan Tahir

Objectives

This study aimed to evaluate the impact of COVID-19 on the prevalence of group B Streptococcus (GBS) colonization and to examine whether the pandemic has influenced pregnancy complications among women colonized by GBS.

Methods

A retrospective chart review was conducted on 2,448 pregnant women who received care at the Outaouais Birthing Center between 2016 and 2023. Pre- and post-pandemic onset data were compared for GBS positive and negative women. Primary outcomes included termination due to miscarriage, transfers (pre- and post-32 weeks, perinatal, postnatal and newborn), reasons for transfers and newborns’ Apgar scores. The secondary outcomes included gestational age at delivery, delivery type and location, newborn birth weight, vaginal birth after cesarean (VBAC) and feeding type. Demographic data were collected to ensure group comparability.

Results

GBS prevalence was similar before (29.43 %) and after (26.59 %) COVID-19 onset (p = 0.06), with a significant spike in 2020 (32.95 %, p = 0.009). An inverse relationship was observed between COVID-19 and newborn transfers in the GBS positive group (p < 0.001). Apgar scores below 7 increased during the pandemic (p = 0.006), and reasons for perinatal transfers differed significantly (p = 0.004). In the GBS negative group, postnatal transfers were negatively correlated with COVID-19 (p < 0.001), and transfer reasons post-32 weeks (p = 0.02), perinatal (p < 0.001), and newborn (p = 0.02) transfers differed significantly.

Conclusion

COVID-19 did not increase the prevalence of GBS in pregnant women. The rise in postpartum transfers and variations in transfer reasons suggest that the pandemic may have influenced healthcare practices rather than directly increasing GBS-related complications.

目的：本研究旨在评估2019冠状病毒病（COVID-19）对B族链球菌（GBS）定植流行率的影响，并探讨该大流行是否影响了GBS定植妇女的妊娠并发症。方法：对2016 - 2023年在Outaouais分娩中心就诊的2448例孕妇进行回顾性图表分析。比较了GBS阳性和阴性妇女在大流行前后的发病数据。主要结局包括流产终止、转移（32周前和32周后、围产期、产后和新生儿）、转移原因和新生儿Apgar评分。次要结局包括分娩时胎龄、分娩类型和地点、新生儿体重、剖宫产后阴道分娩（VBAC）和喂养方式。收集人口统计数据以确保组间可比性。结果：GBS患病率在新冠肺炎发病前（29.43%）和发病后（26.59%）相似（p = 0.06），在2020年显著上升（32.95%,p = 0.009）。在GBS阳性组中，COVID-19与新生儿转移呈反比关系(p)。结论：COVID-19并未增加孕妇GBS的患病率。产后转移的增加和转移原因的变化表明，大流行可能影响了医疗保健做法，而不是直接增加了与gbs相关的并发症。

{"title":"Impact of COVID-19 on Group B Streptococcus Colonization Prevalence And Pregnancy Outcomes: A Single-Center Retrospective Study","authors":"Shuang Wang , Roksana Behruzi , Muhammad Ramzan Tahir","doi":"10.1016/j.srhc.2025.101182","DOIUrl":"10.1016/j.srhc.2025.101182","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aimed to evaluate the impact of COVID-19 on the prevalence of group B <em>Streptococcus</em> (GBS) colonization and to examine whether the pandemic has influenced pregnancy complications among women colonized by GBS.</div></div><div><h3>Methods</h3><div>A retrospective chart review was conducted on 2,448 pregnant women who received care at the Outaouais Birthing Center between 2016 and 2023. Pre- and post-pandemic onset data were compared for GBS positive and negative women. Primary outcomes included termination due to miscarriage, transfers (pre- and post-32 weeks, perinatal, postnatal and newborn), reasons for transfers and newborns’ Apgar scores. The secondary outcomes included gestational age at delivery, delivery type and location, newborn birth weight, vaginal birth after cesarean (VBAC) and feeding type. Demographic data were collected to ensure group comparability.</div></div><div><h3>Results</h3><div>GBS prevalence was similar before (29.43 %) and after (26.59 %) COVID-19 onset (p = 0.06), with a significant spike in 2020 (32.95 %, p = 0.009). An inverse relationship was observed between COVID-19 and newborn transfers in the GBS positive group (p < 0.001). Apgar scores below 7 increased during the pandemic (p = 0.006), and reasons for perinatal transfers differed significantly (p = 0.004). In the GBS negative group, postnatal transfers were negatively correlated with COVID-19 (p < 0.001), and transfer reasons post-32 weeks (p = 0.02), perinatal (p < 0.001), and newborn (p = 0.02) transfers differed significantly.</div></div><div><h3>Conclusion</h3><div>COVID-19 did not increase the prevalence of GBS in pregnant women. The rise in postpartum transfers and variations in transfer reasons suggest that the pandemic may have influenced healthcare practices rather than directly increasing GBS-related complications.</div></div>","PeriodicalId":54199,"journal":{"name":"Sexual & Reproductive Healthcare","volume":"47 ","pages":"Article 101182"},"PeriodicalIF":1.7,"publicationDate":"2025-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145914166","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