Delivery mode preferences and trial of labor after a first cesarean delivery
Delivery mode preferences and trial of labor after a first cesarean delivery
批准号:
9896382
负责人:
Laura B Attanasio
金额:
$8.31万
依托单位国家:
美国
项目类别:
财政年份:
2020
资助国家:
美国
项目状态:
已结题
起止时间:
2020-05-01 至 2022-04-30
关键词:
AddressAffectAgeAttitudeBirthCesarean sectionChildChildbirthConsensusDataData SourcesDevelopmentEmergency department visitEventFeelingFirst BirthsFollow-Up StudiesFrightFundingFutureGoalsGuidelinesHealthHealth StatusHospitalsHypertensionInterventionLabor PainLeadMeasuresNational Institute of Child Health and Human DevelopmentParticipantPatientsPennsylvaniaPerceptionPopulationPostpartum DepressionPostpartum PeriodPregnancyPregnant WomenProspective cohortProviderPsychosocial FactorRecoveryReportingResearchRiskSafetyScheduleShapesTestingThird Pregnancy TrimesterTimeTranslatingTrial of LaborUnited StatesUnited States National Institutes of HealthUnnecessary SurgeryVaginal Birth after CesareanWomanWorkevidence baseexperiencefollow-uphospital readmissioninfant morbidity/mortalitylongitudinal datasetmaternal morbidityperinatal periodpreferencepreventprospectiveshared decision making
中文摘要
项目摘要
大多数有一次剖宫产史的孕妇都适合剖宫产后试产
(TOLAC),但只有约20%的美国妇女与先前剖宫产有TOLAC。重复剖腹产是目前
最常见的剖宫产指征;因此,增加TOLAC的使用是一个重要的
降低剖宫产率的机制。然而,人们对特定的经历如何影响
在第一次怀孕,分娩和产后期间-特别是那些前瞻性测量-影响
发展分娩方式的偏好,为随后的出生,以及如何将这些偏好转化为
交付模式决定。迫切需要更好地了解塑造妇女
交付模式偏好,以指导未来的研究测试方法,支持共同决策
在这个人口中。这项研究将使用来自大规模前瞻性队列的数据来解决
以下具体目标:1)确定如何在第一次怀孕,分娩和产后期间的经验,
形妇女对分娩方式的偏好后,第一胎剖宫产,报告在未来
妊娠;以及2)检查分娩方式偏好与随后试验的关系
在研究随访期间,第二胎妇女的分娩和VBAC。的结果
这项研究将为寻求了解妇女生殖方式的临床医生提供直接相关的信息,
首次剖宫产后的分娩偏好(VBAC或重复剖宫产),并努力做出决定
与患者讨论是否进行试产,同时考虑偏好和风险。
这项研究将增加证据基础,为未来的研究开发干预措施,以支持共享
关于剖腹产后试产的决策。
英文摘要
PROJECT ABSTRACT
Most pregnant women with one prior cesarean birth are appropriate candidates for trial of labor after cesarean
(TOLAC), yet only about 20% of U.S. women with a prior cesarean have a TOLAC. Repeat cesarean is by far
the most common indication for cesarean delivery; therefore, increasing access to TOLAC is an important
mechanism for reducing the rate of cesarean delivery. However, little is known about how specific experiences
in the first pregnancy, birth, and postpartum period – particularly those measured prospectively – impact the
development of delivery mode preferences for a subsequent birth, and how these preferences translate into
delivery mode decisions. There is a critical need to better understand the experiences shaping women's
delivery mode preferences in order to guide future research testing approaches to support shared decision
making in this population. This study will use data from a large-scale, prospective cohort to address the
following specific aims: 1) To determine how experiences in the first pregnancy, birth and postpartum period
shape women's preferences for delivery mode after a first birth by cesarean, reported during the next
pregnancy; and 2) To examine the relationship between delivery mode preferences and subsequent trial of
labor and VBAC among women who had a second birth during the study follow-up period. The results of this
study will provide information directly relevant to clinicians who are seeking to understand women's mode of
delivery preference after first delivery by cesarean (VBAC or repeat cesarean) and to work toward decisions
with their patients about whether or not to have a trial of labor, taking into account both preference and risks.
This research will add to the evidence base for future studies developing interventions to support shared
decision making regarding trial of labor after cesarean.
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会议论文
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批准号:10874022
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项目类别:
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资助金额:$66.56万
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财政年份:2023
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负责人:Laura B Attanasio
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依托单位:
Hospital quality, processes of care, and racial disparities in birth mode for individuals with a prior cesarean
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项目类别:
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财政年份:2023
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负责人:Laura B Attanasio
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依托单位:
The Patient-Provider Relationship and Use of Labor Induction and Cesarean Delivery
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批准号:8997794
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项目类别:
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资助金额:$3.48万
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财政年份:2015
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负责人:Laura B Attanasio
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依托单位:
海外基金