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| Analysis of influencing factors and prediction model of effect of epidural analgesia in labor of primipara |
1.Taizhou Women's and Children's Hospital, Zhejiang Province, 318000； 2. Taizhou Hospital of Zhejiang；
3. Taizhou Central Hospital of Zhejiang |
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Abstract To investigate the effect of epidural analgesia in labor of primipara, and to study its related influencing factors. Methods: A total of 192 primiparas had wanted epidural analgesia in labor were selected by convenience sampling from February 2021 to April 2022. These primiparas were divided in group A (women with good analgesia in labor) and group B (women with poor analgesia in labor) based on the labor pain relief. The maternal clinical data in the two groups were investigated, and the influencing factors of analgesia poor efficacy of the primiparas were analyzed. A predictive model of efficacy of the analgesia of the primiparas was established based on the independent risk factors, the predictive efficacy of which was analyzed by receiver operating characteristic (ROC) curve, and the predictive valued of which was tested by cross-validation. Results: Among the 192 primiparas, 171 (89.1%) primiparas were in group A and 21 (10.9%) primiparas were in group B. Univariate analysis showed that there were significant different in body mass index (BMI), education level, gestational diabetes mellitus, prenatal depression, prenatal anxiety, analgesic timing, and fetal birth weight of the primiparas between the two groups (P＜0.05). Multivariate analysis showed that maternal education level, gestational diabetes mellitus, prenatal depression, prenatal anxiety, analgesic timing, and fetal birth weight of the primiparas were their independent risk factors of poor epidural analgesic effect (P＜0.05). ROC curve analysis showed that the area under the curve (AUC) of the predictive model was 0.939. Cross validation showed that the classification accuracy of the predictive model was 92.7% (178/192). Conclusion: There is still a certain probability of poor epidural analgesia in labor of the primipara. Education level, gestational diabetes mellitus, antenatal depression, antenatal anxiety, analgesia timing, and fetal birth weight of the primiparas all are the risk factors of their poor analgesia, so based on this, targeted interventions can be formulated to improve the analgesic effect.
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