Perineal outcomes and its associated variables of water births versus non-water births: a cross-sectional study

Abstract Objectives: to describe the perineal outcomes of women who had delivered in water and out of water. Methods: a cross-sectional and quantitative study developed in a public hospital in Setúbal, Portugal. The population was of women who participated in the "Water Birth Project" in the period from 2011 to 2014, which gave birth in water and out of water. 104 women were selected according to established inclusion criteria. The groups were compared according to the following variables: demographics, obstetric information, delivery care and perineal outcomes. The data were analyzed in the Stata(r) software, with descriptive and bivariate statistics (chi-square and Fisher's test). Results: the medical records of 73 women who gave birth in water and 31 women who gave birth out of water were studied. Water deliveries were significantly associated with fewer perineal lacerations, lower rates of episiotomy, and shorter delivery time. Conclusions: the results of the study suggest that childbirth in water has a protective effect against severe third or fourth degree perineal tears, during fetal expulsion in water.

摘要 目的：描述水中分娩与非水中分娩产妇的会阴结局。方法：本研究为一项在葡萄牙塞图巴尔市某公立医院开展的横断面定量研究，研究对象为2011年至2014年间参与“水中分娩项目”、分别采用水中分娩与非水中分娩方式的产妇。按照既定纳入标准共筛选出104名产妇，基于人口统计学资料、产科相关信息、分娩护理情况及会阴结局四类变量对两组进行比较。采用Stata(r)软件进行数据分析，包含描述性统计与双变量统计分析（卡方检验及Fisher确切概率法）。结果：共分析73例水中分娩产妇与31例非水中分娩产妇的病历资料，结果显示水中分娩与更少的会阴裂伤、更低的会阴侧切率及更短的产程时长显著相关。结论：本研究结果表明，在水中进行胎儿娩出阶段时，水中分娩对重度Ⅲ度或Ⅳ度会阴撕裂具有保护作用。