摘要
目的评价我国助产士门诊对初产妇分娩方式、妊娠结局的影响。方法采用计算机检索PubMed、Web of Science、CNKI、中国生物医学文献数据库(CBM)、万方数据库中所有助产士门诊对初产妇分娩方式与妊娠结局影响的随机对照试验(RCT)、类实验性研究,并追溯文献综述和参考文献以防漏检。2名评价者独立检索、筛查文献、提取数据、评价纳入文献的方法学质量并交叉核对后,用RevMan 5.2行Meta分析。结果共纳入14项RCT和5项类实验性研究,包括3 861例研究对象。Meta分析结果显示助产士门诊可提高初产妇的自然分娩率(OR=2.71,95%CI为2.33~3.14,P<0.001)、减少初产妇产后大出血的发生率(OR=0.32,95%CI为0.18~0.58,P<0.001)、降低新生儿窒息的发生率(OR=0.22,95%CI为0.11~0.44,P<0.001)、减少巨大儿的发生率(OR=0.31,95%CI为0.21~0.47,P<0.001)。结论助产士门诊能有效提高初产妇的自然分娩率、降低产后大出血、新生儿窒息和巨大儿等不良结局的发生率。
Objective To assess the effects of midwives clinic on delivery mode and childbirth outcomes for primipara. Methods A computerized search in Pub Med, Web of Science, Chinese Biomedical Literature Database（CBM）, China Academic Journal FullText Database（CNKI） and Wanfang Database was performed for relevant randomized controlled trials（RCTs） and quasi-experimental studies on the effects of Chinese midwives clinics on the delivery mode and childbirth outcomes for primipara. Meta-analysis was performed using Rev Man 5.2. Results A total of 14 RCTs and 5 quasi-experimental studies including 3,861 participants were incorporated into the meta-analysis. Meta-analysis results suggested that midwives clinic effectively increased the rate of natural delivery for primiparaous women（OR=2.71, 95%CI：2.33～3.14, P〈0.001）, decreased the incidence of postpartum hemorrhage（OR=0.32, 95% CI：0.18 ～0.58, P〈0.001） and neonatal asphyxia（OR =0.22, 95% CI：0.11 ～0.44, P〈0.001）, and reduced the incidence of neonatal macrosomia（OR=0.31, 95%CI：0.21～0.47, P〈0.001）. Conclusion Midwives clinics can increase the rate of natural delivery for primiparaous women and decrease the incidence of postpartum hemorrhage, neonatal asphyxia and neonatal macrosomia.
出处
《护理学报》
2017年第2期4-10,共7页
Journal of Nursing（China）
关键词
助产士
门诊
初产妇
分娩方式
分娩结局
META分析
nurse midwife
clinic
primipara
delivery mode
childbirth outcomes
Meta-analysis
