Dataset Information

Managing the pain of labour: factors associated with the use of labour pain management for pregnant Australian women.

ABSTRACT:

Background

Despite high rates of women's use of intrapartum pain management techniques, little is known about the factors that influence such use.

Objective

Examine the determinants associated with women's use of labour pain management.

Design

Cross-sectional survey of a substudy of women from the 'young' cohort of the Australian Longitudinal Study of Women's Health (ALSWH).

Setting and participants

Women aged 31-35 years who identified as being pregnant or recently given birth in the 2009 ALSWH survey (n = 2445) were recruited for the substudy. The substudy survey was completed by 1835 women (RR = 79.2%).

Main variables studied

Determinants examined included pregnancy health and maternity care [including complementary and alternative medicine (CAM)] for their most recent pregnancy and any previous pregnancies. Participants' attitudes and beliefs related to both CAM and maternity care were also included in the analysis.

Main outcome measures

The outcome measures examined were the use of both pharmacological and non-pharmacological pain management techniques (NPMT).

Results

Differences were seen in the effects of demographics, health service utilization, health status, use of CAM, and attitudes and beliefs upon use of intrapartum pain management techniques across all categories. The only variable that was identified as a determinant for use of all types of pain management techniques was a previous caesarean section (CS).

Discussion and conclusions

The effect of key determinants on women's use of pain management techniques differs significantly, and, other than CS, no one determinant is clearly influential in the use of all pain management options.

SUBMITTER: Steel A

PROVIDER: S-EPMC5060859 | biostudies-literature | 2015 Oct

REPOSITORIES: biostudies-literature

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Publications

Managing the pain of labour: factors associated with the use of labour pain management for pregnant Australian women.

Steel Amie A Adams Jon J Sibbritt David D Broom Alex A Gallois Cindy C Frawley Jane J

Health expectations : an international journal of public participation in health care and health policy 20131204 5

<h4>Background</h4>Despite high rates of women's use of intrapartum pain management techniques, little is known about the factors that influence such use.<h4>Objective</h4>Examine the determinants associated with women's use of labour pain management.<h4>Design</h4>Cross-sectional survey of a substudy of women from the 'young' cohort of the Australian Longitudinal Study of Women's Health (ALSWH).<h4>Setting and participants</h4>Women aged 31-35 years who identified as being pregnant or recently ...[more]

PMID: 24304970

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Project description:IntroductionMalaria is the leading cause of consultation in Guinea health facilities. During pregnancy, it remains a major health concern causing considerable risks for mother, fetus, and newborn. However, little is known about the epidemiology of malaria among pregnant women in Guinea. We aimed to provide information on malaria-associated factors in parturients.MethodsIt was a cross-sectional survey in two regional hospitals and two district hospitals. 1000 parturients and their newborns were surveyed. All patients were interviewed, and thick and thin blood smears were examined. To determine the predictive factors of malaria in parturients, the Classification and Regression Tree (CART) was first performed by using peripheral and placental malaria as dependent variables and sociodemographic and antenatal characteristics as independent variables; then, explanatory profile variables or clusters from these trees were included in the logistic regression models.ResultsWe found 157 (15.8%) and 148 (14.8%) cases of peripheral and placental malaria, respectively. The regular use of long-lasting insecticide-treated nets (LLINs) before delivery was 53.8%, and only 35.5% used sulfadoxine-pyrimethamine doses ≥3. Factors significantly associated with malaria were as follows: women from Forécariah and Guéckédou who did not regularly use LLINs and accomplished less than four antenatal care visits (ANC <4) and primigravid and paucigravid women who did not regularly use LLINs. Similarly, the odds of having malaria infection were significantly higher among women who had not regularly used LLINs and among primigravid and paucigravid women who had regularly used LLINs compared to multigravida women who had regularly used LLINs.ConclusionThis study showed that pregnant women remain particularly vulnerable to malaria; therefore, strengthening antenatal care visit strategies by emphasizing on promoting the use of LLINs and sulfadoxine-pyrimethamine, sexual education about early pregnancies, and family or community support during first pregnancies might be helpful.

Project description:BackgroundLabour pain has been identified as an important reason for women to prefer caesarean section (CS). Fentanyl is one of the short acting opioids recommended by World Health Organization for pain relief during labour. This study aimed to identify and describe the available evidence on the use of fentanyl (monotherapy) for labour pain management by any routes of administration or regime.MethodsWe included the records published until 31 December 2021 which reported administration of fentanyl to women with normal labour for labour pain relief. Data were extracted by one reviewer and checked by another reviewer using a standardised agreement form. We mapped and presented data descriptively in figure and tabular format.ResultsWe included 51 records from 49 studies in our scoping review. The studies were conducted in 12 countries, mostly high-income countries. The study designs of the 51 included records were varied as follows: 38 (74.5%) experimental studies (35 randomised controlled trials and three quasi-experimental studies), and 12 (23.5%) observational studies (five retrospective cohort studies, four prospective cohort studies, two retrospective descriptive studies, and one descriptive study) and one qualitative study. Of the included records, six used intranasal fentanyl, five used subcutaneous fentanyl, 18 (35.3%) used intravenous fentanyl, 18 (35.3%) used intrathecal fentanyl, and nine used epidural fentanyl. Many records compared fentanyl with another analgesic agent while five records (9.8%) had no comparison group and seven records (13.7%) compared with no analgesia group. The doses of fentanyl varied by routes, study and the requirement depended on the women. Pain assessment was the most frequent outcome measure presented in the records (78.4%). Only nine records (17.6%) investigated women's satisfaction about labour pain relief using fentanyl and seven records (13.7%) reported the effect of fentanyl on breastfeeding. The most common reported neonatal outcomes were foetal heart rate (33 records, 64.7%) and Apgar score (32 records, 62.7%).ConclusionThere is limited primary evidence especially randomised controlled trials to evaluate the effectiveness and harms of different routes of fentanyl in low- or middle-income countries. There is a need for high-quality research to establish the most effective route of fentanyl and associated effects for evidence-based international guidelines.

Dataset Information

Managing the pain of labour: factors associated with the use of labour pain management for pregnant Australian women.

Background

Objective

Design

Setting and participants

Main variables studied

Main outcome measures

Results

Discussion and conclusions

Publications

Managing the pain of labour: factors associated with the use of labour pain management for pregnant Australian women.

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