水中分娩对产妇及新生儿影响的系统评价_《中国循证医学杂志》

作者：

高琦 ^1,2 , 张佩珍 ³ , 高明霞 ^1,2 , 杨克虎 ^1,2 ,  田金徽 ¹

1. 兰州大学循证医学中心（兰州?730000）；2. 兰州大学第一临床医学院（兰州?730000）；3. 兰州市妇幼保健院（兰州?730000）;

关键词：

水中分娩系统评价 Meta分析

DOI：

10.7507/1672-2531.20090147

视频：

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摘要 全文 图表 视频 参考文献 施引文献 补充材料

目的　系统评价水中分娩技术的有效性和安全性。
方法　计算机检索中文科技期刊全文数据库、中国期刊全文数据库、数字化期刊全文数据库、中国生物医学文献数据库、PubMed、EMbase、SCI和Cochrane Library，并辅以其它检索，纳入水中分娩与传统分娩方式比较的随机对照试验，由两位评价者进行资料提取和质量评价后，采用RevMan 5.0软件进行Meta分析。
结果　共纳入11个研究，包括3 963例产妇。Meta分析结果显示：水中分娩在会阴侧切率［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；而在镇痛效果、会阴裂伤、产程及母儿结局方面，两者间差异无统计学意义。
结论　现有证据表明，与传统分娩相比，水中分娩能有效降低产妇会阴侧切率及减少出血，而不会对母儿安全造成新的风险。对于其他方面的评价，尚需要更多研究进一步证实。

引用本文： 高琦,张佩珍,高明霞,杨克虎,田金徽. 水中分娩对产妇及新生儿影响的系统评价. 中国循证医学杂志, 2009, 09(8): 832-839. doi: 10.7507/1672-2531.20090147 复制

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.	蔡红霞, 徐毅, 林燕敏, 等. 水中分娩对产妇及新生儿的影响. 中华护理杂志, 2005, 40(3): 200-201.
16.	董淑筠, 金皖玲, 程蔚蔚, 等. 水中分娩462例临床分析. 上海医学, 2005, 28(9): 737-740.
17.	邹文霞, 朱宁湖. 水中分娩对产程的影响. 临床和实验医学杂志, 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.	施华芳, 赵志丹. 水中分娩的实施和应用前景. 中国妇幼保健, 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. 蔡红霞, 徐毅, 林燕敏, 等. 水中分娩对产妇及新生儿的影响. 中华护理杂志, 2005, 40(3): 200-201.
16. 董淑筠, 金皖玲, 程蔚蔚, 等. 水中分娩462例临床分析. 上海医学, 2005, 28(9): 737-740.
17. 邹文霞, 朱宁湖. 水中分娩对产程的影响. 临床和实验医学杂志, 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. 施华芳, 赵志丹. 水中分娩的实施和应用前景. 中国妇幼保健, 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.

《中国循证医学杂志》

水中分娩对产妇及新生儿影响的系统评价

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《中国循证医学杂志》

水中分娩对产妇及新生儿影响的系统评价

摘要 全文 图表 视频 参考文献 施引文献 补充材料

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