Effectiveness of the professional who carries out the health education program: perinatal outcomes

Figures & data

Table 1 Relationship between type of educator teaching the maternal education program and program characteristics, emergency care, and antepartum anxiety

	Maternal education by midwife		Crude analysis	Multivariate analysis
	No, n (%)	Yes, n (%)	OR (95% CI)	OR (95% CI)
Maternal education sessions (n)
1–3	28 (32.18)	37 (13.86)	1 (ref)	1 (ref)*
>3	59 (67.82)	230 (86.14)	2.95 (1.59–5.39)	2.85 (1.60–5.11)
Hours of maternal education (n)
1–5	30 (35.30)	47 (17.67)	1 (ref)	1 (ref)*
6–10	32 (37.65)	85 (31.95)	1.69 (0.87–3.27)	1.59 (0.84–3.0)
11–15	18 (21.18)	66 (24.82)	2.34 (1.10–4.99)	2.21 (1.08–4.52)
>15	5 (5.87)	68 (25.56)	8.68 (2.99–30.34)	8.06 (2.87–22.61)
P-value of trend			<0.001	<0.001
Unnecessary emergency obstetric care
No	54 (62.07)	188 (70.41)	1 (ref)	1 (ref)*
Yes	33 (37.93)	79 (29.59)	0.69 (0.40–1.19)	0.74 (0.44–1.25)
Antepartum anxiety level
Normal	48 (55.17)	151 (56.77)	1 (ref)	1 (ref)*
Higher	39 (44.83)	115 (44.23)	0.94 (0.56–1.59)	0.99 (0.60–1.64)

Notes:

* Adjusted for marital status, education level, presence of pathology during pregnancy, planned pregnancy, and maternal age.

Abbreviations: CI, confidence interval; OR, odds ratio; ref, reference.

Table 2 Relationship between type of educator teaching the maternal education program and characteristics of delivery

	Maternal education by midwife		Crude analysis	Multivariate analysis
	No, n (%)	Yes, n (%)	OR (95% CI)	OR (95% CI)
Type of delivery
Eutocic	40 (45.98)	144 (53.93)	1 (ref)	1 (ref)*
Dystocic	47 (54.02)	123 (46.07)	0.73 (0.43–1.22)	0.73 (0.44–1.20)
Delivery onset
Spontaneous	45 (51.72)	151 (56.55)	1 (ref)	1 (ref)*
Induced/planned	42 (48.28)	116 (43.45)	0.83 (0.49–1.39)	0.81 (0.49–1.33)
Cesarean delivery
No	66 (75.86)	226 (84.64)	1 (ref)	1 (ref)*
Yes	21 (24.14)	41 (15.36)	0.57 (0.30–1.09)	0.56 (0.30–1.03)
Early skin-to-skin contact between mother and newborn
No	25 (28.74)	52 (19.55)	1 (ref)	1 (ref)*
Yes	62 (71.26)	214 (80.45)	1.67 (0.91–3.03)	1.79 (1.01–3.23)
Medication during dilation
No	19 (21.84)	64 (23.97)	1 (ref)	1 (ref)*
Yes	68 (78.16)	203 (76.03)	0.89 (0.47–1.64)	0.91 (0.50–1.64)
Use of epidural analgesia
No	11 (12.64)	45 (16.85)	1 (ref)	1 (ref)*
Yes	76 (87.36)	222 (83.15)	0.71 (0.32–1.49) Hay	0.85 (0.39–1.82)
Use of nonpharmacological analgesia during delivery
No	70 (80.46)	210 (78.65)	1 (ref)	1 (ref)*
Yes	17 (19.54)	57 (21.35)	1.12 (0.60–2.17)	1.19 (0.63–2.22)
Presence of perineal lesions
No	30 (34.48)	59 (22.10)	1 (ref)	1 (ref)*
Yes	57 (65.52)	208 (77.90)	1.85 (1.05–3.23)	1.89 (1.09–3.23)
Postpartum complications
No	78 (89.66)	240 (89.89)	1 (ref)	1 (ref)*
Yes	9 (10.34)	27 (10.11)	0.98 (0.42–2.17)	0.88 (0.39–2.00)
Active maternal participation in delivery
No	32 (36.78)	61 (22.85)	1 (ref)	1 (ref)**
Yes	55 (63.22)	206 (77.15)	1.96 (1.12–3.45)	1.96 (1.15–3.33)

Notes:

* Adjusted for marital status, education level, presence of pathology during pregnancy, planned pregnancy, and maternal age

** adjusted for marital status, education level, presence of pathology during pregnancy, planned pregnancy, maternal age, and use of epidural analgesia.

Abbreviations: CI, confidence interval; OR, odds ratio; ref, reference.

Table 3 Relationship between type of educator teaching the maternal education program and newborn characteristics

Variable	Maternal education by midwife		Crude analysis	Multivariate analysis
	No, n (%)	Yes, n (%)	OR (95% CI)	OR (95% CI)
Low birth weight (<2,500 g)
No	80 (91.95)	264 (98.88)	1 (ref)	1 (ref)*
Yes	7 (8.05)	3 (1.12)	0.13 (0.02–0.59)	0.14 (0.03–0.65)
Small for gestational age
No	67 (77.01)	208 (78.79)	1 (ref)	1 (ref)*
Yes	20 (22.99)	56 (21.21)	0.91 (0.49–1.72)	0.83 (0.45–1.52)
Admission to intensive care unit
No	83 (95.40)	266 (99.63)	1 (ref)	1 (ref)**
Yes	4 (4.60)	1 (0.37)	0.08 (0.00–0.81)	0.09 (0.01–0.88)
Admission to neonatal unit
No	61 (70.11)	239 (89.51)	1 (ref)	1 (ref)**
Yes	26 (29.89)	28 (10.49)	0.27 (0.14–0.53)	0.32 (0.16–0.66)
Early initation of breastfeeding
No	28 (32.18)	49 (18.35)	1 (ref)	1 (ref)*
Yes	59 (67.82)	218 (81.65)	2.13 (1.18–3.85)	2.08 (1.18–3.70)
Maintenance of breastfeeding 2 months after delivery
No	24 (27.91)	85 (33.07)	1 (ref)	1 (ref)*
Yes	62 (72.09)	172 (66.93)	0.79 (0.44–1.39)	0.73 (0.41–1.30)
Health problems in the first 2 months of life
No	68 (80.00)	218 (83.85)	1 (ref)	1 (ref)**
Yes	17 (20.00)	42 (16.15)	0.78 (0.40–1.56)	0.81 (0.41–1.59)

Notes:

* Adjusted for marital status, education level, presence of pathology during pregnancy, planned pregnancy, and maternal age

** adjusted for low birth weight, small for gestational age, presence of disease during pregnancy, cesarean delivery, and Apgar score at 5 minutes.

Abbreviations: CI, confidence interval; OR, odds ratio; ref, reference.

Table 4 Association between the type of educator teaching the maternal education program and continuous variables

	Crude analysis			Multivariate analysis
	Maternal education by midwife			Maternal education by midwife
	Yes, mean (95% CI)	No, mean (95% CI)	P-value	Yes, mean (95% CI)	No, mean (95% CI)	P-value
Visits for unnecessary emergency obstetric care (n)	0.5 (0.4–0.6)	0.7 (0.4–0.9)	0.071	0.5 (0.4–0.6)	0.6 (0.4–0.8)	0.235##
Pain level during delivery (maximum 10)	7.2 (6.9–7.4)	6.8 (6.3–7.3)	0.209	7.2 (6.9–7.4)	6.9 (6.4–7.4)	0.335##
Length of maternal hospital stay after delivery	2.3 (2.2–2.4)	2.6 (2.3–2.9)	0.094	2.4 (2.3–2.5)	2.4 (2.2–2.5)	0.847***
Woman’s satisfaction with control of pregnancy (0–4)	2.9 (2.8–3.0)	3.1 (2.9–3.3)	0.201	2.9 (2.8–3.0)	3.1 (2.9–3.3)	0.218##
Woman’s satisfaction with the care received during delivery (0–4)	3.2 (3.1–3.3)	3.1 (2.8–3.3)	0.362	3.2 (3.0–3.3)	3.1 (2.9–3.3)	0.449##
Woman’s satisfaction with the maternal education program (0–4)	3.0 (2.9–3.1)	2.5 (2.3–2.7)	<0.001	3.0 (2.9–3.1)	2.5 (2.3–2.7)	<0.001##
Gestational age at delivery	39.5 (39.2–39.8)	39.5 (39.2–39.8)	0.958	39.5 (39.2–39.8)	39.5 (39.1–39.9)	0.976#
Apgar score at 1 minute	8.6 (8.4–8.7)	8.8 (8.6–8.9)	0.054	8.6 (8.5–8.7)	8.8 (8.6–9.0)	0.043*
Apgar score at 5 minutes	9.3 (9.3–9.4)	9.3 (9.2–9.4)	0.710	9.3 (9.3–9.4)	9.3 (9.2–9.4)	0.747*
Length of neonatal hospital stay (days)	2.4 (2.2–2.4)	2.9 (2.3–3.4)	0.024	2.5 (2.3–2.6)	2.7 (2.3–3.0)	0.328***
Duration of dilation (minutes)	398.5 (367.7–429.4)	448.6 (397.3–499.9)	0.112	420.4 (393.4–447.3)	442.9 (395.8–490.0)	0.415**
Duration of expulsive period (minutes)	108.4 (98.9–117.8)	90.9 (76.2–105.6)	0.070	102.5 (93.1–111.9)	84.6 (68.5–100.7)	0.053**
Duration of the third period of delivery (minutes)	9.7 (8.7–10.7)	9.2 (6.4–12.1)	0.708	8.8 (7.6–10.0)	8.7 (6.6–10.7)	0.905**
Woman’s opinion on the utility and benefit of maternal education (0–4)	3.1 (3.0–3.2)	2.7 (2.5–3.0)	0.002	3.1 (3.0–3.2)	2.8 (2.6–3.0)	0.006##

Notes:

* Adjusted for low birth weight, small for gestational age, presence of disease during pregnancy, and cesarean delivery

** adjusted for type of delivery, induction of delivery, use of medication in dilation, use of epidural analgesia, maternal age, marital status, and education level

*** adjusted for cesarean delivery, neonatal hospital admission, presence of disease during pregnancy, and postpartum complications

# adjusted for cesarean delivery, presence of disease during pregnancy, marital status, education level, and maternal age

## adjusted for planned pregnancy, education level, marital status, presence of disease during pregnancy, and maternal age.

Abbreviations: CI, confidence interval; OR, odds ratio.