剖宫产术后再妊娠妇女产前分娩恐惧、社会支持现况及影响其选择分娩方式的相关因素

目的调查剖宫产术后再妊娠妇女产前分娩恐惧、社会支持现状,探讨影响产妇选择分娩方式的相关因素。方法选取2018年7月至2019年7月本院收治的剖宫产术后再次妊娠产妇124例作为研究对象,其中40例产妇选择阴道试产(TOLAC),84例选择剖宫产(ERCS),分别应用分娩恐惧量表和社会支持量表评估TOLAC和ERCS产妇的产前分娩恐惧心理和社会支持情况,并采用多因素logitic回归分析法分析产妇选择不同分娩方式的独立影响因素。结果TOLAC产妇分娩恐惧、对孩子健康恐惧、对疼痛伤害恐惧等得分显著低于ERCS产妇(P<0.05);TOLAC主观支持评分显著高于ERCS(P<0.05);多因素logistic回归分析显示,分娩恐惧、医师分娩建议为影响孕妇选择TOLAC的主要因素(P<0.05)。结论对于剖宫产术后再妊娠妇女医护人员应给予其科学、适合的分娩方式建议,为其提供更多的社会支持,从而减轻产妇分娩前的恐惧心理。

The prenatal delivery fear,social support status and related factors influencing re-pregnant women's choice of delivery methods after cesarean section

Objective To investigate the prenatal delivery fear and social support status of re-pregnant women after cesarean section,and to explore the related factors that affect the delivery methods of pregnant women.Methods We selected 124 cases of pregnant women who were pregnant after cesarean section from July 2018 to July 2019 as the study objects,of which 40 cases of pregnant women chose to undergo trial of labor after cesarean(TOLAC)and 84 cases chose elective repeat cesarean section(ERCS).The delivery fear Scale and social support scale were used to evaluate the prenatal fear psychology and social support of pregnant women with TOLAC and ERCS,and multi-factor logitic regression analysis was used to analyze the independent influencing factors that pregnant women chose different delivery methods.Results The delivery fear,fear of children'health,and fear of pain injury of TOLAC pregnant women were significantly lower than those of ERCS pregnant women(P<0.05),the TOLAC subjective support score was significantly higher than that of ERCS(P<0.05).Multivariate logistic regression analysis showed that the delivery fear and physicians'recommendations for delivery were the main factors that affect the choice of pregnant women with TOLAC(P<0.05).Conclusion Medical staff of re-pregnant women after cesarean section should give them scientific and suitable recommendations of delivery methods and provide them with more social support to reduce the fear psychology of pregnant women before delivery.