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Risk factors and racial disparities related to low maternal birth satisfaction with labor induction: a prospective, cohort study.
BMC Pregnancy and Childbirth ( IF 3.1 ) Pub Date : 2019-12-30 , DOI: 10.1186/s12884-019-2658-z
Rebecca F Hamm 1 , Sindhu K Srinivas 1 , Lisa D Levine 1
Affiliation  

BACKGROUND Decreased birth satisfaction has been associated with labor induction. Yet, there is a paucity of data evaluating risk factors for decreased satisfaction associated with labor induction. We aimed to determine what factors impact low birth satisfaction in labor induction and evaluate racial disparities in birth satisfaction. METHODS We performed a prospective cohort study of women with term, singleton gestations undergoing labor induction at our institution from Jan 2018 to Jun 2018. Women completed the validated Birth Satisfaction Scale-Revised postpartum, which is subdivided into 3 domains: (1) quality of care provision, (2) women's personal attributes, and (3) stress experienced during labor. A total satisfaction score above the mean was classified as "satisfied", and below as "unsatisfied." Domain and item scores were compared by race. RESULTS Three hundred thirty of 414 (79.7%) eligible women were included. There was no significant difference in birth satisfaction by age, body mass index, Bishop score, or labor induction agent. Black women were 75% more likely to be unsatisfied than non-Black women (54.0% vs. 37.2%, OR 1.75 [95% CI 1.11-2.76], p = 0.037), nulliparas were 71% more likely to be unsatisfied than multiparas (54.2% vs. 40.9%, OR 1.71 [95% CI 1.09-2.67], p = 0.019), and women whose labor resulted in cesarean birth were almost 3 times more likely to be unsatisfied than women with a vaginal birth (67.4% vs. 42.3%, OR 2.82 [95% CI 1.69-4.70], p < 0.001). Additionally, increased labor length quartile was associated with decreased satisfaction >(p = 0.003). By race, domain 3 scores, which reflect preparedness for labor, were lower for Black women. No differences were seen for domain 1 or 2. CONCLUSIONS Black race, cesarean birth, and increasing labor length were identified as risk factors for low birth satisfaction among women who underwent labor induction. Further studies should explore interventions to target women at risk for low birth satisfaction.

中文翻译:

与引产时产妇出生满意度低相关的危险因素和种族差异:一项前瞻性队列研究。

背景技术出生满意度降低与引产有关。然而,缺乏数据评估与引产相关的满意度降低的风险因素。我们旨在确定哪些因素会影响引产中的低出生满意度,并评估出生满意度中的种族差异。方法我们于2018年1月至2018年6月在我们机构对接受足月妊娠,单胎妊娠的妇女进行了一项前瞻性队列研究。妇女完成了经验证的产后满意度量表修订的产后检查,分为三个领域:(1)质量提供护理服务;(2)妇女的个人特征;(3)分娩时承受的压力。高于平均水平的总满意度得分被分类为“满意”,低于平均水平的总满意度得分被评为“不满意”。领域和项目得分按种族进行比较。结果纳入414名合格女性中的330名(79.7%)。出生满意度在年龄,体重指数,Bishop评分或引产因素方面无显着差异。黑人妇女的不满意可能性比非黑人妇女高75%(54.0%比37.2%,或1.75 [95%CI 1.11-2.76],p = 0.037),无效者比不满意者多71% (54.2%vs. 40.9%,或1.71 [95%CI 1.09-2.67],p = 0.019),因分娩而分娩的女性不满的概率是阴道分娩的女性的3倍(67.4%) vs. 42.3%,或2.82 [95%CI 1.69-4.70],p <0.001)。此外,劳动时间四分位数的增加与满意度降低>(p = 0.003)相关。按种族划分,领域3的得分反映了对劳动的准备程度,黑人妇女的比例较低。没有发现域1或2的差异。结论在接受引产的女性中,黑人种族,剖宫产和增加的劳动时间被确定为低出生满意度的危险因素。进一步的研究应探索针对低出生满意度风险女性的干预措施。
更新日期:2019-12-31
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