2.50
Hdl Handle:
http://hdl.handle.net/10755/211712
Type:
Research Study
Title:
MODE OF DELIVERY AND MATERNAL AND INFANT RISK FACTORS AND HEALTH OUTCOMES
Abstract:
Background: Childbirth is a necessary stressor. It prepares the infant for extrauterine life, and prepares the mother for lactation and safe return to the non-pregnant state. However, added stressors can have repercussions. Aims: This study aims to describe added stressors (including prenatal maternal socio-demographic and psychological factors) affecting mode of delivery (MOD), and the effect of MOD on mother-infant health at one month postpartum. Methods: Approximately 150 first-time, English-speaking, expectant mothers, at least 18 years of age were recruited from San Francisco, California prenatal clinics for a postpartum sleep intervention clinical trial. They were excluded if they had a sleep or mood disorder, or worked nights. This is a secondary analysis of data from this study. Prenatal maternal socio-demographic and risk factors (depression, anxiety, attitudes/ adjustment, perceived stress) were evaluated by MOD outcome using analysis of variance (ANOVA). Labor induction/augmentation was evaluated, and maternal report of non-reassuring fetal status (NRFS) was the primary outcome variable, analyzed by Chi-Square and logistic regression. Lastly, MOD was evaluated for effect on maternal symptoms of depression and anxiety, infant temperament rating, infant sleep, and breastfeeding continuation at one month using ANOVA and Chi-Square statistics. Results: Prenatal depression and anxiety symptoms were not associated with MOD (normal vaginal, instrument vaginal, cesarean in labor, or scheduled cesarean). Mothers with a prenatal “attitude toward baby” score that was more positive were more likely to have an unplanned cesarean birth. A scheduled cesarean birth was more likely in older women, and those with higher pre-pregnancy BMI. Maternal reports of NRFS were associated with induction/augmentation. One month postpartum measures of maternal symptoms, maternal adjustment, infant temperament, and breastfeeding did not differ by MOD. However, according to maternal sleep diary entries, cesarean-born infants slept an average of one hour more during the day than infants born vaginally. Implications: These findings provide preliminary indication that prenatal attitude toward baby plays a role in MOD, induction/augmentation is associated with increased NRFS, and cesarean birth is associated with increased infant daytime sleep at one month. Nurses should develop, test and implement interventions to minimize prenatal and labor factors that unnecessarily add to delivery stress.
Keywords:
Childbirth; Stress, stressors
Repository Posting Date:
20-Feb-2012
Date of Publication:
20-Feb-2012
Other Identifiers:
4945
Sponsors:
Western Institute of Nursing

Full metadata record

DC FieldValue Language
dc.typeResearch Studyen_GB
dc.titleMODE OF DELIVERY AND MATERNAL AND INFANT RISK FACTORS AND HEALTH OUTCOMESen_GB
dc.identifier.urihttp://hdl.handle.net/10755/211712-
dc.description.abstractBackground: Childbirth is a necessary stressor. It prepares the infant for extrauterine life, and prepares the mother for lactation and safe return to the non-pregnant state. However, added stressors can have repercussions. Aims: This study aims to describe added stressors (including prenatal maternal socio-demographic and psychological factors) affecting mode of delivery (MOD), and the effect of MOD on mother-infant health at one month postpartum. Methods: Approximately 150 first-time, English-speaking, expectant mothers, at least 18 years of age were recruited from San Francisco, California prenatal clinics for a postpartum sleep intervention clinical trial. They were excluded if they had a sleep or mood disorder, or worked nights. This is a secondary analysis of data from this study. Prenatal maternal socio-demographic and risk factors (depression, anxiety, attitudes/ adjustment, perceived stress) were evaluated by MOD outcome using analysis of variance (ANOVA). Labor induction/augmentation was evaluated, and maternal report of non-reassuring fetal status (NRFS) was the primary outcome variable, analyzed by Chi-Square and logistic regression. Lastly, MOD was evaluated for effect on maternal symptoms of depression and anxiety, infant temperament rating, infant sleep, and breastfeeding continuation at one month using ANOVA and Chi-Square statistics. Results: Prenatal depression and anxiety symptoms were not associated with MOD (normal vaginal, instrument vaginal, cesarean in labor, or scheduled cesarean). Mothers with a prenatal “attitude toward baby” score that was more positive were more likely to have an unplanned cesarean birth. A scheduled cesarean birth was more likely in older women, and those with higher pre-pregnancy BMI. Maternal reports of NRFS were associated with induction/augmentation. One month postpartum measures of maternal symptoms, maternal adjustment, infant temperament, and breastfeeding did not differ by MOD. However, according to maternal sleep diary entries, cesarean-born infants slept an average of one hour more during the day than infants born vaginally. Implications: These findings provide preliminary indication that prenatal attitude toward baby plays a role in MOD, induction/augmentation is associated with increased NRFS, and cesarean birth is associated with increased infant daytime sleep at one month. Nurses should develop, test and implement interventions to minimize prenatal and labor factors that unnecessarily add to delivery stress.en_GB
dc.subjectChildbirthen_GB
dc.subjectStress, stressorsen_GB
dc.date.available2012-02-20T12:09:54Z-
dc.date.issued2012-02-20T12:09:54Z-
dc.date.accessioned2012-02-20T12:09:54Z-
dc.description.sponsorshipWestern Institute of Nursingen_GB
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