A comparison of childbirth self-efficacy, fear of childbirth, and labor pain intensity between primiparas and multiparas during the latent phase of labor: a cross-sectional study.

BACKGROUND: Childbirth is a long-lasting physiological stress. As one of the main stressors, labor pain exists throughout the whole process. Childbirth self-efficacy is the confidence, or belief that they can manage pain during childbirth. This sense of self-efficacy determines how pregnant women deal with labor pain and enables them to regulate their behavior and actively deal with childbirth. However, the difference in pain sensitivity between single births (primiparas) and multiple births (multiparas) has rarely been investigated. OBJECTIVES: This study is aimed at investigating self-efficacy, fear of childbirth, labor pain of primiparas and multiparas and exploring factors related to the perceived labor pain intensity of pregnant women. DESIGN: Prospective cross-sectional study. SETTING(S): Labour and delivery in a large academic specialized hospital in Guangzhou, China. PARTICIPANTS: A total of 347 women, (182 primiparas and 165 multiparas) were enrolled in the data analysis. Pain was assessed before cervical dilatation (cervical dilatation ≤ 3 cm for the first delivery and ≤ 2 cm for the second delivery). METHOD: The general information of participants was obtained by questionnaire and obstetrical records of the subjects were obtained from the electronic medical records extracted from the electronic medical record system (EMRS). Childbirth self-efficacy, fear of childbirth (FOC) and labor pain were compared between primiparas and multiparas. Paired t-test, chi-square test, Mann-Whitney test, univariate and multivariate regression analysis were used to analyze labor pain between the two groups and investigate factors related perceived labor pain intensity. RESULTS: The total scores related to fear of childbirth, fetal health, self-control, and labor pain injury of multiparas were notably reduced compared with primiparas (all P < 0.05). The perceived labor pain intensity and duration of the first stage of labor was reduced in the multipara group compared with the primipara group. The childbirth control sense of the multipara was better than that of the primipara. The perceived labor pain intensity was negatively correlated with advanced age (age ≥ 35 years), self-efficacy score, family support, and education (all P < 0.05). In contrast, the perceived labor pain intensity was positively correlated with tension, severe fear of childbirth, and anxiety (P < 0.05). Self-efficacy, gravidity, delivery cognition, and fear of childbirth were independent risk factors for the perceived labor pain intensity in the latent period (all P < 0.05). CONCLUSIONS: Fear of childbirth is a predictor of perceived labor pain intensity. The extent of labor pain (minimum and maximum) can be predicted by the level of fear the expectant mother has. During the latent phase of labor, self-efficacy, fear of childbirth and labor pain are different between primiparas and multiparas.

Relatively high-substrate consistency hydrolysis of steam-pretreated sweet sorghum bagasse at relatively low cellulase loading.

Sweet sorghum bagasse (SSB) was steam pretreated in the conditions of 190 °C for 5 min to assess its amenability to the pretreatment and enzymatic hydrolysis. Results showed that pretreatment conditions were robust enough to pretreat SSB with maximum of 87% glucan and 72% xylan recovery. Subsequent enzymatic hydrolysis showed that the pretreated SSB at 2% substrate consistency resulted in maximum of 70% glucan-glucose conversion. Increasing substrate consistency from 2% to 16% led to a significant reduction in glucan conversion. However, the decrease ratio of glucan-glucose conversion was the minimum when the consistency increased from 2% to 12%. When the pretreated SSB consistency of 12% was applied for hydrolysis, increase in cellulase loading from 7.5 up to 20 filter paper units (FPU)/g glucan resulted only in 14% increase in glucan-glucose conversion compared to 20% increase with cellulase loading varying from 2.5 to 7.5 FPU/g glucan. More than 10 cellobiase units (CBU)/g glucan ß-glucosidase supplementation had no noticeable improvement on glucan-glucose conversion. Additionally, supplementation of xylanase was found to significantly increase glucan-glucose conversion from 50% to 80% with the substrate consistency of 12%, when the cellulase and ß-glucosidase loadings were at relatively low enzyme loadings (7.5 FPU/g and 10 CBU/g glucan). It appeared that residual xylan played a critical role in hindering the ease of hydrolysis of SSB. A proper xylanase addition was suggested to achieve a high hydrolysis yield at relatively high substrate consistency with relatively low enzyme loadings.