水中分娩對產婦及新生兒影響的系統評價_《中國循證醫學雜志》

作者：

高琦 ^1,2 , 張佩珍 ³ , 高明霞 ^1,2 , 楊克虎 ^1,2 ,  田金徽 ¹

1. 蘭州大學循證醫學中心（蘭州?730000）；2. 蘭州大學第一臨床醫學院（蘭州?730000）；3. 蘭州市婦幼保健院（蘭州?730000）;

關鍵詞：

水中分娩系統評價 Meta分析

DOI：

10.7507/1672-2531.20090147

視頻：

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目的　系統評價水中分娩技術的有效性和安全性。
方法　計算機檢索中文科技期刊全文數據庫、中國期刊全文數據庫、數字化期刊全文數據庫、中國生物醫學文獻數據庫、PubMed、EMbase、SCI和Cochrane Library，并輔以其它檢索，納入水中分娩與傳統分娩方式比較的隨機對照試驗，由兩位評價者進行資料提取和質量評價后，采用RevMan 5.0軟件進行Meta分析。
結果　共納入11個研究，包括3 963例產婦。Meta分析結果顯示：水中分娩在會陰側切率［OR= 0.09，95%CI（0.01，–?0.59）］和失血量［MD= –?36.02，95%CI（–?55.24，–?16.79）］方面低于普通分娩方式；而在鎮痛效果、會陰裂傷、產程及母兒結局方面，兩者間差異無統計學意義。
結論　現有證據表明，與傳統分娩相比，水中分娩能有效降低產婦會陰側切率及減少出血，而不會對母兒安全造成新的風險。對于其他方面的評價，尚需要更多研究進一步證實。

引用本文： 高琦,張佩珍,高明霞,楊克虎,田金徽. 水中分娩對產婦及新生兒影響的系統評價. 中國循證醫學雜志, 2009, 09(8): 832-839. doi: 10.7507/1672-2531.20090147 復制

1.	Embry M. Observation surunaccouchement termina dansle bain. Ann. Soc Med. Prat Montpellier, 1805, 5: 13-19.
2.	Machey MM. Use of water in labor and birth. Clinical Obstetrics and Gynecology, 2001, 44(4): 733-749.
3.	Edlich RF, Towler MA, Goitz RJ, et al. Bioengineering principles of hydrotherapy. J Burn Care Rehabil, 1987, 8(6): 580-584..
4.	Church LK. Water birth: one birthing center’s observations. J Nurse Midwifery, 1989, 34(4): 165-170.
5.	Geissbühler V, Eberhard J. Waterbirths: a comparative study. A prospective study on more than 2,000 waterbirths. Fetal Diagn Ther, 2000, 15(5): 291-300.
6.	Garland D, Jones K. Waterbirth: updating the evidence. British Journal of Midwifery, 1997, 5(6): 368-373.
7.	Schorn MN, McAllister JL, Blanco JD. Water immersion and the effect on labor. J Nurse Midwifery, 1993, 38(6): 336-342.
8.	Alderdice F, Renfrew M, Marchant S, et al. Labour and birth in water in England and Wales: survey report. British Journal of Midwifery, 1995, 3(7): 376-382.
9.	Waterbirths BE. MIDIRS Midwifery Digest, 2001, 11(3): S10-13.
10.	Rosevear SK, Fox R, Marlow N, et al. Birthing pools and the fetus. Lancet, 1993, 342: 1048-1049.
11.	Hawkins S. Water versus conventional birth: infections rates compared. Nursing Times, 1995, 91(15): 38-40.
12.	Deans AC, Steer PH. Temperature of pool is important. BMJ, 1995, 311: 390-391.
13.	Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5. 0. 1[updated February 2008]. The Cochrane Collaboration, 2008. Available from www. cochrane-handbook. org.
14.	Review Manager (RevMan) [Computer program]. Version 5. 0. Copenhagen: The Nordic Cochrane Centre, The Cochrane Collaboration, 2008.
15.	蔡紅霞, 徐毅, 林燕敏, 等. 水中分娩對產婦及新生兒的影響. 中華護理雜志, 2005, 40(3): 200-201.
16.	董淑筠, 金皖玲, 程蔚蔚, 等. 水中分娩462例臨床分析. 上海醫學, 2005, 28(9): 737-740.
17.	鄒文霞, 朱寧湖. 水中分娩對產程的影響. 臨床和實驗醫學雜志, 2008, 7(6): 137.
18.	Cammu H, Clasen K, Van Wettere L, et al. ’To bathe or not to bathe’ during the first stage of labor. Acta Obstet Gynecol Scand, 1994, 73(6): 468-472.
19.	Eckert K, Turnbull D, MacLennan A. Immersion in water in the first stage of labor: a randomized controlled trial. Birth, 2001, 28(2): 84-93.
20.	Cluett ER, Pickering RM, Getliffe K, et al. Randomised controlled trial of labouring in water compared with standard of augmentation for management of dystocia in first stage of labour. BMJ, 2004, 328(7442): 767-768.
21.	Ohlsson G, Buchhave P, Leandersson U, et al. Warm tub bathing during labor: maternal and neonatal effects. Acta Obstet Gynecol Scand, 2001, 80(4): 311-314.
22.	Rush J, Burlock S, Lambert K, et al. The effects of whirlpools baths in labor: a randomized, controlled trial. Birth, 1996, 23(3): 136-143.
23.	Taha M. The effects of water on labour: a randomised controlled trial. Rand Afrikaans University South Africa, 2000.
24.	Schorn MN, McAllister JL, Blanco JD. Water immersion and the effect on labor. Journal of Nurse-Midwifery, 1993, 38(6): 336-342.
25.	Zanetti-Daellenbach RA, Tschudin S. Maternal and neonatal infections and obstetrical outcome in water birth. Eur J Obstet Gynecol Reprod Biol, 2007, 134(1): 37-43.
26.	施華芳, 趙志丹. 水中分娩的實施和應用前景. 中國婦幼保健, 2007(22): 284-286.
27.	De Punzio C, Neri E, Metelli P, et al. The relationship between maternal relaxation and plasma beta-endorphin levels during parturition. J Psychosom Obstet Gynaecol, 1994, 15(4): 205-210.
28.	Schorn MN, McAllister JL, Blanco JD. Water immersion and the effect on labor. J Nurse Midwifery, 1993, 38(6): 336-342.
29.	Geissbuehler V, Stein S, Eberhard J. Waterbirths compared with landbirths: an observational study of nine years. J Perinat Med, 2004, 32(4): 308-314.
30.	Bodner K, Bodner-Adler B, Wierrani F, et al. Effects of water birth on maternal and neonatal outcomes. Wien Klin Wochenschr, 2002, 114(10-11): 391-395.

1. Embry M. Observation surunaccouchement termina dansle bain. Ann. Soc Med. Prat Montpellier, 1805, 5: 13-19.
2. Machey MM. Use of water in labor and birth. Clinical Obstetrics and Gynecology, 2001, 44(4): 733-749.
3. Edlich RF, Towler MA, Goitz RJ, et al. Bioengineering principles of hydrotherapy. J Burn Care Rehabil, 1987, 8(6): 580-584..
4. Church LK. Water birth: one birthing center’s observations. J Nurse Midwifery, 1989, 34(4): 165-170.
5. Geissbühler V, Eberhard J. Waterbirths: a comparative study. A prospective study on more than 2,000 waterbirths. Fetal Diagn Ther, 2000, 15(5): 291-300.
6. Garland D, Jones K. Waterbirth: updating the evidence. British Journal of Midwifery, 1997, 5(6): 368-373.
7. Schorn MN, McAllister JL, Blanco JD. Water immersion and the effect on labor. J Nurse Midwifery, 1993, 38(6): 336-342.
8. Alderdice F, Renfrew M, Marchant S, et al. Labour and birth in water in England and Wales: survey report. British Journal of Midwifery, 1995, 3(7): 376-382.
9. Waterbirths BE. MIDIRS Midwifery Digest, 2001, 11(3): S10-13.
10. Rosevear SK, Fox R, Marlow N, et al. Birthing pools and the fetus. Lancet, 1993, 342: 1048-1049.
11. Hawkins S. Water versus conventional birth: infections rates compared. Nursing Times, 1995, 91(15): 38-40.
12. Deans AC, Steer PH. Temperature of pool is important. BMJ, 1995, 311: 390-391.
13. Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5. 0. 1[updated February 2008]. The Cochrane Collaboration, 2008. Available from www. cochrane-handbook. org.
14. Review Manager (RevMan) [Computer program]. Version 5. 0. Copenhagen: The Nordic Cochrane Centre, The Cochrane Collaboration, 2008.
15. 蔡紅霞, 徐毅, 林燕敏, 等. 水中分娩對產婦及新生兒的影響. 中華護理雜志, 2005, 40(3): 200-201.
16. 董淑筠, 金皖玲, 程蔚蔚, 等. 水中分娩462例臨床分析. 上海醫學, 2005, 28(9): 737-740.
17. 鄒文霞, 朱寧湖. 水中分娩對產程的影響. 臨床和實驗醫學雜志, 2008, 7(6): 137.
18. Cammu H, Clasen K, Van Wettere L, et al. ’To bathe or not to bathe’ during the first stage of labor. Acta Obstet Gynecol Scand, 1994, 73(6): 468-472.
19. Eckert K, Turnbull D, MacLennan A. Immersion in water in the first stage of labor: a randomized controlled trial. Birth, 2001, 28(2): 84-93.
20. Cluett ER, Pickering RM, Getliffe K, et al. Randomised controlled trial of labouring in water compared with standard of augmentation for management of dystocia in first stage of labour. BMJ, 2004, 328(7442): 767-768.
21. Ohlsson G, Buchhave P, Leandersson U, et al. Warm tub bathing during labor: maternal and neonatal effects. Acta Obstet Gynecol Scand, 2001, 80(4): 311-314.
22. Rush J, Burlock S, Lambert K, et al. The effects of whirlpools baths in labor: a randomized, controlled trial. Birth, 1996, 23(3): 136-143.
23. Taha M. The effects of water on labour: a randomised controlled trial. Rand Afrikaans University South Africa, 2000.
24. Schorn MN, McAllister JL, Blanco JD. Water immersion and the effect on labor. Journal of Nurse-Midwifery, 1993, 38(6): 336-342.
25. Zanetti-Daellenbach RA, Tschudin S. Maternal and neonatal infections and obstetrical outcome in water birth. Eur J Obstet Gynecol Reprod Biol, 2007, 134(1): 37-43.
26. 施華芳, 趙志丹. 水中分娩的實施和應用前景. 中國婦幼保健, 2007(22): 284-286.
27. De Punzio C, Neri E, Metelli P, et al. The relationship between maternal relaxation and plasma beta-endorphin levels during parturition. J Psychosom Obstet Gynaecol, 1994, 15(4): 205-210.
28. Schorn MN, McAllister JL, Blanco JD. Water immersion and the effect on labor. J Nurse Midwifery, 1993, 38(6): 336-342.
29. Geissbuehler V, Stein S, Eberhard J. Waterbirths compared with landbirths: an observational study of nine years. J Perinat Med, 2004, 32(4): 308-314.
30. Bodner K, Bodner-Adler B, Wierrani F, et al. Effects of water birth on maternal and neonatal outcomes. Wien Klin Wochenschr, 2002, 114(10-11): 391-395.

《中國循證醫學雜志》

水中分娩對產婦及新生兒影響的系統評價

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《中國循證醫學雜志》

水中分娩對產婦及新生兒影響的系統評價

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