자연 출산 병원에서 출산한 여성의 회음부 손상에 미치는 영향 요인
Factors Influencing Perineal Injury in Women Giving Birth in Natural Childbirth Hospitals
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Purpose: This study aimed to identify the factors affecting the degree of perineal injury in women who gave birth at a natural childbirth hospital. Methods: This descriptive correlational study aimed to confirm the effect of delivery at a natural childbirth hospital on perineal injury in women. We analyzed the medical records of 358 women who gave birth naturally to infants in the cephalic position at >37 weeks gestation in 2018 at an obstetric clinic in Seoul. Data were analyzed using Spearman rank correlation coefficient to identify variables affecting perineal injury, and multiple regression was used to identify the factors affecting perineal injury. IBM SPSS version 28.0 for windows was used for data analysis. Results: There were significant negative correlations between the degree of perineal injury and birth order (r=- 0.73, p<0.001), number of previous vaginal deliveries (r=-0.70, p<0.001), and age (r=-0.30, p<0.001). However, there were significant positive correlations between the degree of perineal injury and parity (r=0.83, p<0.001), labor duration in stage I (r=0.35, p<0.001), labor duration in stage II (r=0.37, p<0.001), fluid hydration (r=0.28, p<0.001), epidural anesthesia (r=0.27, p<0.001), and oxygen supply (r=0.26, p<0.001). Factors affecting the degree of perineal injury were parity (b=0.10, p=0.007) and birth order (b=-0.09, p=0.014), and the explanatory power of this model was 52.0% (F=130.054, p<0.001). Conclusion: The degree of perineal injury was highest in the primiparous group and decreased as the birth order increased. Therefore, to prevent perineal injury during childbirth, nursing care with minimal intervention such as epidural anesthesia is required for primiparous women.
Abstract
Purpose: This study aimed to identify the factors affecting the degree of perineal injury in women who gave birth at a natural childbirth hospital. Methods: This descriptive correlational study aimed to confirm the effect of delivery at a natural childbirth hospital on perineal injury in women. We analyzed the medical records of 358 women who gave birth naturally to infants in the cephalic position at >37 weeks gestation in 2018 at an obstetric clinic in Seoul. Data were analyzed using Spearman rank correlation coefficient to identify variables affecting perineal injury, and multiple regression was used to identify the factors affecting perineal injury. IBM SPSS version 28.0 for windows was used for data analysis. Results: There were significant negative correlations between the degree of perineal injury and birth order (r=- 0.73, p<0.001), number of previous vaginal deliveries (r=-0.70, p<0.001), and age (r=-0.30, p<0.001). However, there were significant positive correlations between the degree of perineal injury and parity (r=0.83, p<0.001), labor duration in stage I (r=0.35, p<0.001), labor duration in stage II (r=0.37, p<0.001), fluid hydration (r=0.28, p<0.001), epidural anesthesia (r=0.27, p<0.001), and oxygen supply (r=0.26, p<0.001). Factors affecting the degree of perineal injury were parity (b=0.10, p=0.007) and birth order (b=-0.09, p=0.014), and the explanatory power of this model was 52.0% (F=130.054, p<0.001). Conclusion: The degree of perineal injury was highest in the primiparous group and decreased as the birth order increased. Therefore, to prevent perineal injury during childbirth, nursing care with minimal intervention such as epidural anesthesia is required for primiparous women.
참고문헌 (27)
- Al-Ghammari K, "Predictors of routine episiotomy in primigravida women in Oman", Appl Nurs Res, 29, pp.131~135 (2016)
- American College of Obstetricians and Gynecologists’ Committee on Practice Bulletins—Obstetrics, "Practice Bulletin No. 165 Summary: prevention and management of obstetric lacerations at vaginal delivery", Obstet Gynecol, 128, pp.226~227 (2016)
- Barca JA, "Risk factors in third and fourth degree perineal tears in women in a tertiary centre : an observational ambispective cohort study", J Pers Med, 11, pp.685~ (2021)
- Chia CC, "Third-and fourth-degree perineal laceration in vaginal delivery", Taiwan J Obstet Gynecol, 51, pp.148~152 (2012)
- 강정화, "수중 출산에서 산모와 신생아의 성과; 일개 자연출산병원의 3년간 자료를 바탕으로", 한국모자보건학회지, 23(3), pp.147~154 (2019), 한국모자보건학회[DOI]
- Garcia-Lausin L, "Relation between Epidural Analgesia and severe perineal laceration in childbearing women in Catalonia", Midwifery, 70, pp.76~83 (2019)
- Gebuza G, "Episiotomy and perineal tear risk factors in a group of 4493 women", Health Care Women Int, 39, pp.663~683 (2018)
- Goueslard K, "How did episiotomy rates change from 2007 to 2014? Populationbased study in France", BMC Pregnancy Childbirth, 18, pp.208~ (2018)
- Gupta JK, "Position in the second stage of labour for women without epidural anaesthesia", Cochrane Database Syst Rev, 5, pp.CD002006~ (2017)
- Hauck YL, "Risk factors for severe perineal trauma during vaginal childbirth : a Western Australian retrospective cohort study", Women Birth, 28, pp.16~20 (2015)
- Hsieh WC, "Prevalence and contributing factors of severe perineal damage following episiotomy-assisted vaginal delivery", Taiwan J Obstet Gynecol, 53, pp.481~485 (2014)
- 장현정, "분만 시 회음부 손상과 산후 우울간의 관계", 문화기술의 융합, 4(1), pp.111~117 (2018), 국제문화기술진흥원[DOI]
- 정혜윤, "신규간호사의 간호전문직관과 직무몰입이 이직의도에 미치는 영향", 간호행정학회지, 22(5), pp.531~539 (2016), 간호행정학회[DOI]
- Kim KA, "The Correlations between the characteristics related to vaginal normal delivery and perineal laceration in pregnant women", pp.2022
- 김경원, "자연주의 출산한 여성의 출산실태와 회음부 손상: 일개 자연주의 출산 병원 의무기록을 중심으로", 여성건강간호학회지, 27(4), pp.379~387 (2021), 한국여성건강간호학회[DOI]
- Kim SA, "Comparison of thirddegree lacerations according to the episiotomy or non-episiotomy. Korean Society of Obstet and Gynecol Conference", Matern Fetal Med, OB-24, pp.250~ (2014)
- Kwon HY, "Episiotomy and the risk of severe perineal injuries among Korean women", J Matern Fetal Neonatal Med, 30, pp.1745~1749 (2017)
- 이은주, "조산원 출산 여성의 ‘자연출산’ 의미와 경험 - 페미니스트 접근", 여성건강간호학회지, 18(2), pp.135~148 (2012), 한국여성건강간호학회[DOI]
- Lee SH, "Effect on the perineal damage of natural childbirth women in midwifery clinic", The 47th Korean Society of Women's Health Nurs Spring Conference, pp.293~ (2017), Korean Society of Women Health Nursing
- Marshall J, "Myles textbook for midwives", pp.317~319 (2016), Elsevier
- 박지미, "자연주의 출산에서 간호사 주도 듈라지지 프로그램 개발 및 효과: 예비 연구", 한국모자보건학회지, 23(4), pp.269~279 (2019), 한국모자보건학회[DOI]
- Pergialiotis V, "Risk factors for severe perineal trauma during childbirth : an updated meta-analysis", Eur J Obstet Gynecol Reprod Biol, 247, pp.94~100 (2020)
- Pergialiotis V, "Risk factors for severe perineal lacerations during childbirth", Int J Gynaecol Obstet, 125, pp.6~14 (2014)
- Rodrigues S, "Intact perineum : what are the predictive factors in spontaneous vaginal birth?", Mater Sociomed, 31, pp.25~30 (2019)
- Sangkomkamhang U, "Restrictive versus routine episiotomy among Southeast Asian term pregnancies : a multicentre randomised controlled trial", BJOG, 127, pp.397~403 (2020)
- Women's Health Nursing Research Association, "Women's Health Nurs Ⅱ", pp.390~ (2018), Soomoonsa
- "WHO recommendations: Intrapartum care for a positive childbirth experience" (2018)[URL]