Re: [新聞] 懷孕婦女建議側睡以降低死胎風險

[aracian (arabian-c)]

想請問幾個問題

第一，這篇研究設計在2014年提出的收案數是希望 有415個控制組和830個對照組

報告出來的結果是 291個控制組和 733個對照組
文章當中解釋這個數字依然可以達成:
detect an odds ratio (OR) of 1.5 with a significance level of 0.05 and power
of 80%. 的目標

在討論中也有提到願意參加研究的比例是45%

雖然文章當中解釋願意和不願意參加的人在年齡和種族上相近，

但文章當中沒有提出其他說明來強調這個參與比例對研究結果的影響

關於這個部分，是不是我漏看了什麼?



第二，就像2017年 在紐西蘭的這篇

Going to sleep in the supine position is a modifiable risk factor for late
pregnancy stillbirth; Findings from the New Zealand multicentre stillbirth
case-control study
肿
PLoS One. 2017; 12(6): e耰179396.뼊Published online 2017 Jun 13. doi:  10.1371/journal.pone.0179396


這篇是採用這篇問卷設計的方式來詢問婦女檢查前一天的睡覺姿勢

但在奧克蘭研究當中，他們還特別強調為了減少回憶造成的誤差

他們使用了影片輔助(有另一篇Ref.)

我不知道這篇是不是有採用類似的方式減少誤差，我可能快速看過沒有看出來

想請問文章當中有特別強調他們如何避免這類誤差嗎?

---

看完的心得，左側睡其實理論上對胎兒會比較好

但以目前的研究，也還沒達到研究者所希望達成像"嬰兒仰睡運動"減少猝死的類似證據

也因此建議和呼籲左側睡是OK的，但如果面對失去胎兒的婦女，

千萬不要拿著這些研究出來的報告施加壓力給家長

準媽媽們可以考慮左側睡姿勢入睡(入睡即可，不用一直擔心睡後跟起床的姿勢)，

但如果真的無法達成，就放寬心吧


(跟台灣母奶哺餵感覺有點類似，好的研究被過度解釋後就好有壓力)

(不知道以後會不會有孕婦左側躺協會，或是納入母嬰親善醫院評鑑標準?)


最後，其實文章當中除了側睡與否

還有其他的風險因子檢測結果，我覺得也很有趣，可惜文章當中沒有針對這些進行討論

http://onlinelibrary.wiley.com/store/10.1111/1471-0528.14967/asset/supinfo/
bjo14967-sup-0002-TableS2.pdf?v=1&s=073af73bd87ce121ee7a38c63050ff52cd8841a5






※ 引述《bluetree0224 (幸福快樂的每一天願爲主,)》之銘言：
: 先寫重點：
: 1.入睡時建議側睡，睡醒時什麼姿式無妨
: 2.午睡小睡也要避免仰睡
: 3.懷孕第三期應盡量避免仰睡
: 4.假如你半夜醒來發現自己仰睡，建議再改回側睡
: 心得：懷第一胎時，不仰睡我完全睡不著，仰睡到生；第二胎則是第3週起不側睡睡不著
: ，每胎胎僻好像都不太一樣，但為了寶寶好，盡量遵守專家建議囉！
: 內文：
: Women advised to sleep on side to help prevent stillbirth
: Women are being advised to sleep on their side in the last three months of pre
: gnancy to help prevent stillbirth.
: A study of just over 1,000 women found the risk doubles if women go to sleep o
: n their backs in the third trimester.
: The study looked into 291 pregnancies that ended in stillbirth and 735 women w
: ho had a live birth.
: Researchers say the position which women fall asleep in is most important - an
: d they should not worry if they are on their back when they wake up.
: About one in 225 pregnancies in the UK ends in stillbirth and the study author
: s estimate that about 130 babies' lives a year could be saved if women went to
:  sleep on their side.
: （The MiNESS study, published in the British Journal of Obstetrics and Gynaeco
: logy (BJOG) is the biggest of its kind, and confirms findings from smaller stu
: dies in New Zealand and Australia.）
: Is waking up on your back a problem?
: Prof Alexander Heazell, clinical director at the Tommy's Stillbirth Research C
: entre at St Mary's Hospital in Manchester, who led the research, advises women
:  in their third trimester to sleep on their side for any episode of sleep, inc
: luding daytime naps.
: "What I don't want is for women to wake up flat on their back and think 'oh my
:  goodness I've done something awful to my baby'.
: "The question that we asked was very specifically what position people went to
:  sleep in and that's important as you spend longer in that position than you d
: o in any other.
: "And also you can't do anything about the position that you wake up in but you
:  can do something about the position you go to sleep."
: line break
: Tips for going to sleep on your side
: Put a pillow or pillows behind your back to encourage side-sleeping
: If you wake during the night, check your position and go back to sleep on your
:  side
: Pay the same attention to sleep position during the day as you would during th
: e night
: If you wake on your back during the night, don't worry, just roll on to your s
: ide
: The study didn't find a difference in risk between right or left side
: 文章出處
: http://www.bbc.com/news/health-42025835?ocid=socialflow_facebook&ns_mchannel=s
: ocial&ns_campaign=bbcnews&ns_source=facebook

--
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※ 文章網址: https://www.ptt.cc/bbs/BabyMother/M.1511229823.A.134.html
※ 編輯: aracian (223.139.237.122), 11/21/2017 10:10:55
※ 編輯: aracian (61.216.57.6), 11/21/2017 10:24:22
※ 編輯: aracian (61.216.57.6), 11/21/2017 10:24:58
推 mirrorhide  : 孕婦左側躺協會XDDDD
推 choping     : 我就是長期左躺 結果生完後左背容易酸痛@@
推 jasmine0902 : 推您的嚴謹態度
→ mRENm       : 孕婦左側躺協會XDDDD
→ mRENm       : 感覺煩躁XD 一舉一動都是壓力
推 maggiekiki  : 我的醫生是叫我能睡著就好～XDDD 但我是右側睡才能
→ maggiekiki  : 入睡，結果10個月下來，壓壞肩膀...到現在小孩2歲也
→ maggiekiki  : 沒好，只更嚴重...
推 arctic      : 我左側躺小孩就會抗議一下子就宮縮...看個人
推 yjeu        : 其實睡著後不可能一直維持左側臥，我自己懷孕時可
→ yjeu        : 能太常側躺，結果肚子歪掉，妊娠紋跟剖腹的傷口都是
→ yjeu        : 左邊比較多跟比較凸...
推 cindys      : 孕婦左側躺協會XDDDD