بررسی ارتباط ترس از زایمان، اضطراب پنهان و کیفیت خواب در بارداری با پیامد زایمانی در زنان نخست زا

نوع مقاله: اصیل پژوهشی

نویسندگان

1 کارشناس ارشد مامایی، گروه مامایی و بهداشت باروری، دانشکده علوم پزشکی، دانشگاه تربیت مدرس تهران، تهران، ایران.

2 استادیار گروه مامایی و بهداشت باروری، دانشکده پزشکی، دانشگاه تربیت مدرس تهران، تهران، ایران

3 دانشیار گروه آمار زیستی، دانشکده پزشکی، دانشگاه تربیت مدرس تهران، تهران، ایران.

چکیده

مقدمه: اضطراب و ترس از زایمان ممکن است در سه ماهه آخر بارداری با عوارض مامایی، تجربه منفی زایمانی و
افزایش سزارین همراه باشد. مطالعه حاضر با هدف بررسی ارتباط اضطراب، ترس از زایمان و کیفیت خواب در سه
ماهه آخر بارداری با طول لیبر، القاء لیبر و روش زایمان انجام شد.
روشکار: در این مطالعه طولی آینده نگر، 156 زن باردار نخست زا با بارداری تک قلوی طبیعی )سن بارداری28-33
هفته( مراجعه کننده به مراکز بهداشتی– درمانی قم در سال 1383 به طور تصادفی وارد مطالعه شدند. متغیرهای
پیش بین شامل: اضطراب، ترس از زایمان و کیفیت خواب به ترتیب با سه پرسشنامه استاندارد: سنجش اضطراب
پنهان اسپیل برگر )STAI-T(، پرسشنامه نگرش زایمان )CAQ( و پرسشنامه کیفیت خواب پیتزبورگ )PSQI(
سنجیده شدند. متغیرهای پیامد زایمانی شامل: القاء لیبر، لیبر طول کشیده و روش زایمان از طریق پرونده های
پزشکی افراد ثبت شد. داده ها از طریق آزمون های کای دو، تحلیل رگرسیون لجستیک و آزمون همبستگی پیرسون
و با استفاده از نرم افزار آماری SPSS )نسخه 16( تحلیل شدند. میزان p کمتر از 3/35 معنی دار در نظر گرفته شد.
یافتهها: بین اضطراب پنهان، لیبر القاء شده و سزارین انتخابی ارتباط معنی داری وجود داشت )p=3/30(،
)p=3/331(. همچنین در گروه مادران مضطرب، احتمال القاء لیبر و سزارین انتخابی به ترتیب 2 و 13 برابر بیشتر بود
 سزارین و لیبر القاء ،کشیده طول لیبر با اضطراب بین اما .)CI=1/2-85 OR=13/3( )CI=1/1-0/5 OR=2/1(
اورژانسی ارتباط معنی داری مشاهده نشد )p<3/1(. بین نمرات ترس از زایمان و کیفیت خواب با لیبر القاء شده و
طول کشیده، زایمان سزارین ارتباط معنی داری مشاهده نشد )p<3/1(.
نتیجهگیری: بین اضطراب پنهان و لیبر القاء شده و سزارین انتخابی ارتباط معنی داری وجود دارد.

کلیدواژه‌ها


عنوان مقاله [English]

Fear of Childbirth, Trait Anxiety and Quality Sleep in Pregnancy and Birth Outcomes in Nulliparous Woman

نویسندگان [English]

  • Zahra Alipour 1
  • Minoo Lamyian 2
  • Ebrahim Hajizadeh 3
1 M.Sc. of Midwifery, Department of Midwifery and Health Reproductive, Faculty of Medicine, Tarbiat Modares University, Tehran, Iran.
3 Associate Professor, Department of Biostatistics, Faculty of Medicine, Tarbiat Modares University, Tehran, Iran.
چکیده [English]

Introduction: Anxiety and fear of childbirth in the last trimester of pregnancy, possibly is associated with complications of obstetrics, negative experiences and increased cesarean delivery. This study was aimed to study about relationship between anxiety, fear of childbirth and quality of sleep in the third trimester of pregnancy and length of labor, induction of labor and method of delivery.
Methods: In this prospective longitudinal study, 156 pregnant women (23-30 weeks) 2010 who referred to ten health centers in the Qom-­­Iran were included with simple random method. The predictor variables were the anxiety, fear of childbirth and quality sleep scores measured using the spielbrger's trait anxiety inventory, childbirth attitudes questionnaire and Pittsburgh Sleep Quality Index­. The outcome variables were four obstetric complications: induced labor; prolonged labor; emergency cesarean section and method of delivery. Data were analyzed through­­ chi-square test; logistic regression and Pearson correlation ­using SPSS softwareversion 16 was performed. P value less than 0.05 was considered statistically significant.
Results: Relation between trait anxiety in late pregnancy with induced labor and elective caesarean section significant (p=­0.04), (p=­0.001). Women who anxious had an increased risk for elective cesarean section and induced labor (OR=10.3; CI=­1.2–85), (OR=2.1; CI=­1.1–4.5), but not for; ­prolonged labor; emergency cesarean section (p>0.1). Between scores of fear of childbirth and sleep quality with induced labor, ­prolonged labor, emergency and elective caesarean section had not significant relationship (p>0.1).
Conclusions: Trait anxiety had significant relation with elective cesarean section and induced labor and high prevalence of caesarean.

کلیدواژه‌ها [English]

  • Anxiety
  • Cesarean section
  • Fear of childbirth
  • Induced and ­prolonged labor
  • Sleep Quality
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