Patterns of Labour Interventions and Associated Maternal Biopsychosocial Factors in Australia: a Path Analysis.
Australia
Caesarean section birth
Episiotomy
Instrumental birth
Labour interventions
Longitudinal
Pregnancy outcomes
Journal
Reproductive sciences (Thousand Oaks, Calif.)
ISSN: 1933-7205
Titre abrégé: Reprod Sci
Pays: United States
ID NLM: 101291249
Informations de publication
Date de publication:
09 2023
09 2023
Historique:
received:
15
12
2022
accepted:
09
03
2023
medline:
7
9
2023
pubmed:
28
3
2023
entrez:
27
3
2023
Statut:
ppublish
Résumé
In Australia, nearly half of births involve labour interventions. Prior research in this area has relied on cross-sectional and administrative health data and has not considered biopsychosocial factors. The current study examined direct and indirect associations between biopsychosocial factors and labour interventions using 19 years of population-based prospective data. The study included singleton babies among primiparous women of the 1973-1978 cohort of the Australian Longitudinal Study on Women's Health. Data from 5459 women who started labour were analysed using path analysis. 42.2% of babies were born without intervention (episiotomy, instrumental, or caesarean delivery): Thirty-seven percent reported vaginal birth with episiotomy and instrumental birth interventions, 18% reported an unplanned caesarean section without episiotomy and/or instrumental interventions, and 3% reported unplanned caesarean section after episiotomy and/or instrumental interventions. Vaginal births with episiotomy and/or instrumental interventions were more likely among women with chronic hypertension (RRR(95%-CI):1.50(1.12-2.01)), a perceived length of labour of more than 36 h (RRR(95%-CI):1.86(1.45-2.39)), private health insurance (RRR(95%-CI):1.61(1.41-1.85)) and induced labour (RRR(95%-CI):1.69(1.46-1.94)). Risk factors of unplanned caesarean section without episiotomy and/or instrumental birth intervention included being overweight (RRR(95%-CI):1.30(1.07-1.58)) or obese prepregnancy (RRR(95%-CI):1.63(1.28-2.08)), aged ≥ 35 years (RRR(95%-CI):1.87(1.46-2.41)), having short stature (< 154 cm) (RRR(95%-CI):1.68(1.16-2.42)), a perceived length of labour of more than 36 h (RRR(95%-CI):3.26(2.50-4.24)), private health insurance (RRR(95%-CI):1.38(1.17-1.64)), and induced labour (RRR(95%-CI):2.56(2.16-3.05)). Prevention and management of hypertension, diabetes, and obesity during preconception and/or antenatal care are keys for reducing labour interventions and strengthening the evidence-base around delivery of best practice obstetric care.
Identifiants
pubmed: 36973581
doi: 10.1007/s43032-023-01219-7
pii: 10.1007/s43032-023-01219-7
pmc: PMC10480095
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
2767-2779Informations de copyright
© 2023. The Author(s).
Références
PLoS Med. 2020 May 22;17(5):e1003103
pubmed: 32442207
Epidemiology. 2017 Jul;28(4):575-579
pubmed: 28346268
BMC Health Serv Res. 2013 Jan 31;13:36
pubmed: 23368720
BJOG. 2013 May;120(6):732-42; discussion 742-3
pubmed: 23510385
Women Birth. 2017 Aug;30(4):282-290
pubmed: 27889259
Glob Heart. 2016 Mar;11(1):71-79.e4
pubmed: 27102024
BMC Public Health. 2013 Jan 09;13:16
pubmed: 23302258
Matern Child Health J. 2017 May;21(5):1175-1184
pubmed: 28102500
J Psychosom Res. 2019 Oct;125:109795
pubmed: 31421320
PLoS One. 2020 Jan 3;15(1):e0227325
pubmed: 31899773
BMJ Open. 2018 Mar 2;8(3):e019509
pubmed: 29500211
Aust N Z J Obstet Gynaecol. 2019 Dec;59(6):799-804
pubmed: 30773610
Biom J. 2018 May;60(3):431-449
pubmed: 29292533
PLoS One. 2017 Aug 4;12(8):e0181794
pubmed: 28783742
Aust N Z J Obstet Gynaecol. 2017 Feb;57(1):40-48
pubmed: 28251626
Aust J Gen Pract. 2018 Dec;47(12):877-882
pubmed: 31212408
Sci Rep. 2019 Sep 11;9(1):13101
pubmed: 31511586
Women Health. 1998;28(1):23-40
pubmed: 10022055
Early Hum Dev. 2007 Aug;83(8):497-504
pubmed: 17071023
Lancet. 2018 Oct 13;392(10155):1358-1368
pubmed: 30322586
Proc Biol Sci. 2019 Feb 13;286(1896):20182425
pubmed: 30963921
Br Med J (Clin Res Ed). 1984 Sep 8;289(6445):587-90
pubmed: 6432201
J Obstet Gynaecol Can. 2020 Mar;42(3):293-300
pubmed: 31324481
Cochrane Database Syst Rev. 2015 Jun 02;(6):CD000032
pubmed: 26031211
Lancet. 2016 Oct 29;388(10056):2176-2192
pubmed: 27642019
Women Birth. 2014 Dec;27(4):281-91
pubmed: 25070731
BMJ Open. 2021 Mar 8;11(3):e041502
pubmed: 34006023
BMC Pregnancy Childbirth. 2015 Aug 04;15:161
pubmed: 26238999
Int J Epidemiol. 2016 Apr;45(2):565-75
pubmed: 27097747
Bull World Health Organ. 2013 May 1;91(5):350-6
pubmed: 23678198
Ann Oncol. 2014 Apr;25(4):889-895
pubmed: 24667721
Bull World Health Organ. 2020 Jan 1;98(1):66-68
pubmed: 31902964
Arch Gynecol Obstet. 2012 Jun;285(6):1513-6
pubmed: 22187064
Springerplus. 2013 May 14;2(1):222
pubmed: 23853744
BMJ Open. 2017 May 9;7(5):e013413
pubmed: 28490549
BMC Pregnancy Childbirth. 2019 Jul 4;19(1):226
pubmed: 31272397
Matern Child Health J. 2018 Jun;22(6):830-840
pubmed: 29411252
Birth. 2016 Dec;43(4):358-365
pubmed: 27500501