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

Wangel, Anne-Marie; Molin, Johan LU ; Östman, Margareta and Jernström, Helena LU (2011) In Acta Obstetricia et Gynecologica Scandinavica 90(3). p.238-244
Abstract
Objective. To identify predictors as free-text markers for mental ill-health from an electronic perinatal record (EMR) system and the association with emergency cesarean section (CS) in nulliparous women. Material and methods. This was a population-based study using an EMR system, set in the catchment area of Malmö University Hospital in Sweden. Of 10 662 nulliparous women presenting with a singleton cephalic baby for vaginal delivery between 2001 and 2006, 6 467 women with complete EMRs were selected. A free-text search of markers for mental ill-health was carried out, and results were analysed by multivariate logistic regression. Eleven markers for mental ill-health were tested with Cohen's kappa for agreement and used as exposure... (More)
Objective. To identify predictors as free-text markers for mental ill-health from an electronic perinatal record (EMR) system and the association with emergency cesarean section (CS) in nulliparous women. Material and methods. This was a population-based study using an EMR system, set in the catchment area of Malmö University Hospital in Sweden. Of 10 662 nulliparous women presenting with a singleton cephalic baby for vaginal delivery between 2001 and 2006, 6 467 women with complete EMRs were selected. A free-text search of markers for mental ill-health was carried out, and results were analysed by multivariate logistic regression. 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 intervals (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 (95% CI 1.14-2.16); and worry, adjusted OR 1.41 (95% CI 1.10-1.79). Conclusion. Free-text words in medical records that indicated 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. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Acta Obstetricia et Gynecologica Scandinavica
volume
90
issue
3
pages
238 - 244
publisher
Wiley-Blackwell
external identifiers
  • wos:000288825600006
  • pmid:21306317
  • scopus:79952011519
ISSN
1600-0412
DOI
10.1111/j.1600-0412.2010.01056.x
language
English
LU publication?
yes
id
006413e3-4df0-4232-8ad2-93611aaf8eaf (old id 1832070)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/21306317?dopt=Abstract
date added to LUP
2011-03-01 13:47:23
date last changed
2017-10-08 04:02:46
@article{006413e3-4df0-4232-8ad2-93611aaf8eaf,
  abstract     = {Objective. To identify predictors as free-text markers for mental ill-health from an electronic perinatal record (EMR) system and the association with emergency cesarean section (CS) in nulliparous women. Material and methods. This was a population-based study using an EMR system, set in the catchment area of Malmö University Hospital in Sweden. Of 10 662 nulliparous women presenting with a singleton cephalic baby for vaginal delivery between 2001 and 2006, 6 467 women with complete EMRs were selected. A free-text search of markers for mental ill-health was carried out, and results were analysed by multivariate logistic regression. 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 intervals (CI) were calculated for emergency CS, and adjusted for maternal age, diabetes, epidural anesthesia and gestational weeks &lt;37 and &gt;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 (95% CI 1.14-2.16); and worry, adjusted OR 1.41 (95% CI 1.10-1.79). Conclusion. Free-text words in medical records that indicated 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.},
  author       = {Wangel, Anne-Marie and Molin, Johan and Östman, Margareta and Jernström, Helena},
  issn         = {1600-0412},
  language     = {eng},
  number       = {3},
  pages        = {238--244},
  publisher    = {Wiley-Blackwell},
  series       = {Acta Obstetricia et Gynecologica Scandinavica},
  title        = {Emergency cesarean sections can be predicted by markers for stress, worry and sleep disturbances in first-time mothers.},
  url          = {http://dx.doi.org/10.1111/j.1600-0412.2010.01056.x},
  volume       = {90},
  year         = {2011},
}