Maternal childbirth experience and time of delivery: a retrospective 7-year cohort study of 105 847 parturients in Finland.

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Tytuł:: Maternal childbirth experience and time of delivery: a retrospective 7-year cohort study of 105 847 parturients in Finland.
Autorzy:: Joensuu J; Faculty of Management and Business, Tampere University, Tampere, Finland .; Department of Obstetrics and Gynaecology, Helsinki University Hospital, Helsinki, Finland.
Saarijärvi H; Faculty of Management and Business, Tampere University, Tampere, Finland.
Rouhe H; Department of Obstetrics and Gynaecology, Helsinki University Hospital, Helsinki, Finland.; Faculty of Medicine, University of Helsinki, Helsinki, Finland.
Gissler M; Information, Finnish Institute of Health and Welfare, Helsinki, Finland.; Division of Family Medicine, Karolinska Institute Department of Neurobiology, Care Sciences and Society, Huddinge, Sweden.
Ulander VM; Department of Obstetrics and Gynaecology, Helsinki University Hospital, Helsinki, Finland.
Heinonen S; Department of Obstetrics and Gynaecology, Helsinki University Hospital, Helsinki, Finland.; Faculty of Medicine, University of Helsinki, Helsinki, Finland.
Mikkola T; Department of Obstetrics and Gynaecology, Helsinki University Hospital, Helsinki, Finland.; Folkhälsän Research Center, Biomedicum, Helsinki, Finland.
Źródło:: BMJ open [BMJ Open] 2021 Jun 16; Vol. 11 (6), pp. e046433. Date of Electronic Publication: 2021 Jun 16.
Typ publikacji:: Journal Article; Research Support, Non-U.S. Gov't
Język:: English
Imprint Name(s):: Original Publication: [London] : BMJ Publishing Group Ltd, 2011-
MeSH Terms:: Labor, Induced*
Parturition*
Cohort Studies ; Female ; Finland ; Humans ; Pregnancy ; Retrospective Studies
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Contributed Indexing:: Keywords: epidemiology; health services administration & management; obstetrics
Entry Date(s):: Date Created: 20210617 Date Completed: 20210618 Latest Revision: 20210702
Update Code:: 20240104
PubMed Central ID:: PMC8211041
DOI:: 10.1136/bmjopen-2020-046433
PMID:: 34135044
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Objectives: To explore how the time of delivery influences childbirth experience.
Design: A retrospective cohort study.
Setting: Childbirth in the four Helsinki and Uusimaa Hospital District hospitals, Finland, from 2012 to 2018.
Participants: 105 847 childbirths with a singleton live fetus.
Main Outcome Measures: Childbirth experience measured by Visual Analogue Scale (VAS).
Results: The major difference in average childbirth experience measured by VAS was between primiparas (8.03; 95% CI 8.01 to 8.04) and multiparas (8.47; 95% CI 8.45 to 8.48). Risk ratio (RR) of the low VAS (≤5) was 2.3 when primiparas were compared with multiparas. Differences in VAS between distinct periods were found in two stages: annual and time of day. The decrease in VAS from 2012-2016 to 2017-2018 in primiparas was from 7.97 (95% CI 7.95 to 7.99) to 7.80 (95% CI 7.77 to 7.83) and from 2014-2016 to 2017-2018 in multiparas from 8.60 (95% CI 8.58 to 8.61) to 8.49 (95% CI 8.47 to 8.52). Corresponding RRs of low VAS were 1.3 for primiparas and 1.2 for multiparas. Hourly differences in VAS were detected in primiparas between office hours 08:00-15:59 (7.97; 95% CI 7.94 to 7.99) and other times (night 00:00-07:59; 7.91; 95% CI 7.88 to 7.94; and evening 16:00-23:59; 7.90; 95% CI 7.87 to 7.92). In multiparas differences in VAS were detected between evening (8.52; 95% CI 8.50 to 8.54) and other periods (night; 8.56; 95% CI 8.54 to 9.58; and office hours; 8.57; 95% CI 8.55 to 8.59).
Conclusion: The maternal childbirth experience depended on the time of delivery. Giving birth during the evening led to impaired childbirth experience in both primiparas and multiparas, compared with delivery at other times. The impact of labour induction on childbirth experience should be further examined. The reorganisation of delivery services and the reduction of birth preparations might affect annual VAS. VAS is a simple method of measuring the complex entity of childbirth experience, and our results indicate its ability to capture temporal variation.
Competing Interests: Competing interests: None declared.
(© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

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