Influence of non-pharmacological obstetric interventions on adverse outcomes of childbirth under regional analgesia

J Perinat Med. 2020 Jun 25;48(5):495-503. doi: 10.1515/jpm-2019-0366.

Abstract

Background We examined the influence of companionship and the use of complementary therapies on adverse outcomes in parturients under regional analgesia. Methods This study is a single-center retrospective cohort of 986 term pregnant women, and it was based on data from medical records (hospitalization period: November 2012-November 2018). The women were in the active phase of labor under regional analgesia. A statistical program was used to search for an association between companionship and the use of complementary therapies with sample data. Bi- and multivariate logistic regressions based on significant associations were used to analyze the potential intervening variables in the adverse outcomes. Results Models were constructed for each of the maternal adverse outcomes. Childbirth complications were significantly associated with complementary therapies [adjusted odds ratio (AOR) = 0.42; 95% confidence interval (CI) = 0.28-0.63; P < 0.001] and companionship (AOR = 0.36; 95% CI = 0.22-0.57; P < 0.001). Prolonged maternal hospitalization was significantly associated with companionship (AOR = 0.57; 95% CI = 0.36-0.92; P < 0.05). Unplanned cesarean section showed a significant association with complementary therapies (AOR = 0.05; 95% CI = 0.01-0.47; P < 0.01). Conclusion The likelihood of childbirth complications and prolonged maternal hospitalization is reduced by companionship, whereas the likelihood of childbirth complications and cesarean section rates is reduced by the use of complementary therapies.

Keywords: labor pain; non-pharmacological methods; obstetric anesthesia; obstetric labor; outcomes; women’s health.

MeSH terms

  • Adult
  • Anesthesia, Conduction / methods
  • Anesthesia, Conduction / statistics & numerical data
  • Anesthesia, Obstetrical / methods
  • Anesthesia, Obstetrical / statistics & numerical data
  • Brazil / epidemiology
  • Cesarean Section / methods
  • Cesarean Section / statistics & numerical data
  • Complementary Therapies* / methods
  • Complementary Therapies* / psychology
  • Complementary Therapies* / statistics & numerical data
  • Delivery, Obstetric* / methods
  • Delivery, Obstetric* / statistics & numerical data
  • Female
  • Friends / psychology*
  • Humans
  • Length of Stay / statistics & numerical data
  • Obstetric Labor Complications* / prevention & control
  • Obstetric Labor Complications* / psychology
  • Obstetric Labor Complications* / therapy
  • Outcome and Process Assessment, Health Care
  • Pregnancy
  • Women's Health