Emergency cesarean sections can be predicted by markers for stress, worry and sleep disturbances in first-time mothers

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Emergency cesarean sections can be predicted by markers for stress, worry and sleep disturbances in first-time mothers

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Publication Article, peer reviewed scientific
Title Emergency cesarean sections can be predicted by markers for stress, worry and sleep disturbances in first-time mothers
Author(s) Wangel, Anne-Marie ; Molin, Johan ; Östman, Margareta ; Jernström, Helena
Date 2011
English abstract
Abstract Objective: To identify predictors as free-text markers for mental ill-health from an electronic perinatal record (EMR) system and the association for emergency cesarean section (CS) in nulliparous women. Design: Population-based study using an EMR system. Setting: The catchment area of Malmö University Hospital in Sweden. Population: 6 467 women with complete perinatal electronic records (EMR) were selected of 10 662 nulliparous women presenting with a singleton cephalic baby for vaginal delivery between 2001 and 2006. Methods: Free-text search of markers for mental ill-health and multivariate logistic regression. Main Outcome Measures: Eleven markers for mental ill-health were tested with Cohen’s kappa for agreement and used as exposure variables. Odds ratios (OR) with 95% confidence interval (CI) were calculated for emergency CS, and adjusted for maternal age, diabetes, epidural anesthesia, and gestational weeks <37 and >41 by a multivariate logistic regression model with vaginal delivery as the reference. Results: Three markers identified from the EMR system reached statistically significant associations with an increased risk for emergency CS in nulliparous women: stress adjusted OR 1.66 (95% CI 1.34–2.06), sleep adjusted OR 1.57 (1.14–2.16), and worry adjusted OR 1.41 (1.10–1.79). Conclusions: Free-text words in medical records, indicating stress, sleep disturbances, or worry predicted increased adjusted OR for emergency CS in first-time mothers. Recognizing pregnant women’s reporting of their mental health status could have a predictive bearing on delivery outcomes.
DOI http://dx.doi.org/10.1111/j.1600-0412.2010.01056.x (link to publisher's fulltext)
Publisher Wiley-Blackwell
Host/Issue Acta Obstetricia et Gynecologica Scandinavica;3
Volume 90
ISSN 1600-0412
Pages 238-244
Language eng (iso)
Subject(s) Cesarean section
markers
sleep
stress
worry
Medicine
Research Subject Categories::MEDICINE
Handle http://hdl.handle.net/2043/12629 (link to this page)

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