上海市宝山区产妇泌乳Ⅱ期启动延迟发生现状及影响因素

doi:10.12183/j.scjpm.2021.1493

摘要/Abstract

摘要： 目的探讨上海市宝山区产妇泌乳Ⅱ期启动延迟发生现状及影响因素。方法以上海市宝山区某医院2020年1—12月住院分娩的产妇为研究对象进行产妇泌乳II期启动情况跟踪随访,采用自制调查问卷收集产妇产后抑郁、焦虑及疲乏情况,采用描述流行病学分析方法对上海地区产妇泌乳Ⅱ期启动延迟发生情况进行分析,并采用单、多因素方法分析启动延迟的影响因素。结果 1 188名产妇年龄平均为（28.11±3.48）岁,产妇泌乳II期启动时间为（74.67±5.22） h,312例发生泌乳II期启动延迟,发生率为26.26%。年龄≥35岁、合并妊娠期高血压、合并妊娠期糖尿病、剖宫产、初产妇、产后开奶时间≥30 min、产后抑郁、产后焦虑、产后疲乏的产妇泌乳II期启动延迟发生率较高（P<0.05或P<0.01）。多因素Logistic回归分析结果显示,年龄≥35岁（OR=2.516）、合并妊娠期高血压（OR=2.520）、合并妊娠期糖尿病（OR=2.994）、剖宫产（OR=1.578）、初产妇（OR=2.164）、产后开奶时间≥30 min（OR=1.091）、产后抑郁（OR=3.769）、产后焦虑（OR=3.174）是产妇泌乳Ⅱ期启动延迟的危险因素。结论上海市宝山区产妇泌乳II期启动延迟发生率相对较高,产妇年龄≥35岁、妊娠期高血压、妊娠期糖尿病、剖宫产、初产妇、产后开奶时间≥30 min、产后抑郁、产后焦虑等因素是影响产妇泌乳II期启动延迟的危险因素,应针对上述危险因素进行识别及干预,以降低泌乳II期启动延迟的发生率。

关键词: 产妇, 泌乳II期启动延迟, 现况研究, 影响因素

Abstract: Objective To study the status and influencing factors of delayed initiation of lactation phase Ⅱ in parturients in Baoshan district of Shanghai. Methods Taking parturients who were hospitalized in a hospital in Shanghai from January to December 2020 as the research object to follow up the initiation of lactation phase II, the self-made questionnaire was used to collect postpartum depression, anxiety and fatigue. The descriptive epidemiological analysis method was used to analyze the occurrence of delayed initiation of lactation phase Ⅱ in parturients in Shanghai, and univariate and multivariate analysis methods were used to analyze the influencing factors of the delay. Results The average age of 1 188 parturients was （28.11 ± 3.48） years. The time of lactation phase II initiation was （74.67 ± 5.22） h. A total of 312 cases had delayed initiation of lactation phase Ⅱ, with an incidence rate of 26.26%. There was a higher incidence of delayed initiation of lactation phase Ⅱ in parturients with an age of ≥ 35 years, gestational hypertension, gestational diabetes, cesarean section, primipara, time from birth to lactation ≥ 30 min, postpartum depression, postpartum anxiety and postpartum fatigue （all P<0.05 or P<0.01）. Multivariate Logistic regression analysis showed that age ≥ 35 years old （OR=2.516）, complicated with gestational hypertension （OR=2.520）, complicated with gestational diabetes （OR=2.994）, cesarean section （OR=1.578）, primipara （OR=2.164）, time from birth to lactation ≥ 30 min （OR=1.091）, postpartum depression （OR=3.769）, and postpartum anxiety （OR=3.174） were risk factors for the delayed initiation of lactation phaseⅡ. Conclusion The incidence of delayed initiation of lactation phase Ⅱ is relatively high in Baoshan district, Shanghai. Age ≥35 years old, gestational hypertension, gestational diabetes, cesarean section, primipara, time from birth to lactation ≥ 30 min, postpartum depression, and postpartum anxiety were risk factors of delayed initiation of lactation phaseⅡ. The above risk factors should be identified and intervened to reduce the incidence of delayed initiation of lactation phase Ⅱ.

Key words: Parturient, Delayed initiation of lactation phase Ⅱ, Status, Influencing factor

中图分类号:

R174

黄海丽, 顾晓青, 封红伟. 上海市宝山区产妇泌乳Ⅱ期启动延迟发生现状及影响因素[J]. 华南预防医学, 2021, 47(12): 1493-1496.

HUANG Hai-li, GU Xiao-qing, FENG Hong-wei. Status and influencing factors of delayed initiation of lactation phase Ⅱ in parturients in Baoshan District, Shanghai[J]. South China Journal of Preventive Medicine, 2021, 47(12): 1493-1496.

参考文献

[1] Ratnayake HE, Rowel D.Prevalence of exclusive breastfeeding and barriers for its continuation up to six months in Kandy district, Sri Lanka[J]. Int Breas J, 2018, 13(1): 1-8.
[2] Robinson H, Buccini G, Curry L, et al.The World Health Organization code and exclusive breastfeeding in China, India, and Vietnam[J]. Mater Child Nutr, 2019, 15(1): 1-11.
[3] 周倩倩. 国内母乳喂养门诊工作流程[J].实用临床护理学电子杂志,2018,3(36):194-195.
[4] Lee MK, Binns C.Breastfeeding and the risk of infant illness in Asia: A review[J]. Int J Environ Res Pub He,2020,17(1): 186.
[5] Gardner W, Kassebaum N.Global, regional, and national prevalence and trends in infant breastfeeding status in 204 countries and territories, 1990-2019[J]. Curr Dev Nutr, 2020, 4(Suppl 2): 992-992.
[6] 张青,李世珍,刘青锋,等.四川省泸州市纯母乳喂养现状及其影响因素分析[J].华南预防医学,2020,46(5):494-497.
[7] Fok D, Aris IM, Ho J, et al.Early initiation and regular breast milk expression reduces risk of lactogenesis II delay in at-risk Singaporean mothers in a randomised trial[J]. Singap Med J, 2019, 60(2): 80.
[8] Demirci J, Schmella M, Glasser M, et al.Delayed lactogenesis II and potential utility of antenatal milk expression in women developing late-onset preeclampsia: A case series[J]. BMC Pregnancy Childb, 2018, 18(1): 1-10.
[9] Rocha BO, Machado MP, Bastos LL, et al.Risk factors for delayed onset of lactogenesis II among primiparous mothers from a Brazilian baby-friendly hospital[J]. J Hum Lact, 2020, 36(1): 146-156.
[10] 胡珊珊,刘君,蒋盘华,等.产妇泌乳Ⅱ期启动延迟发生率及影响因素的系统评价[J].中国全科医学, 2021, 24(24):3110-3115.
[11] 毋小茜. 爱丁堡产后抑郁量表在产后抑郁症筛查中的应用[J].国际精神病学杂志,2020, 47(2):155-158,166
[12] 孙振晓,刘化学,焦林瑛,等.医院焦虑抑郁量表的信度及效度研究[J].中华临床医师杂志(电子版), 2017, 11(2):198-201.
[13] 钱璇,徐旭娟,张凤,等.中文版产后疲乏量表的信效度检验[J].护理学杂志,2020, 35(13):33-36.
[14] 林少虹,徐春燕.高龄产妇泌乳启动延迟的影响因素分析[J].实用临床医学,2019,20(9):92-94.
[15] 滕智敏,谈小雪,周英姿,等.高龄产妇泌乳启动延迟现状及相关因素分析[J].护理学杂志,2018,33(10):33-35.8.
[16] Bonifacino E, Schwartz EB, Jun H, et al.Effect of lactation on maternal hypertension: A systematic review[J]. Breastfeed Med, 2018, 13(9): 578-588.
[17] 刘怀昌,肖磊,徐智立,等.妊娠期高血压疾病对孕妇动脉弹性和血管内皮功能的影响[J].中华高血压杂志,2019,27(4):372-375.
[18] 栾丹丹,于秀荣,王云芳,等.NICU住院早产儿母亲在母婴分离期的泌乳量及相关因素研究[J].中华护理杂志,2018,53(1):65-70.
[19] Ley SH, Chavarro JE, Li M, et al.Lactation duration and long-term risk for incident type 2 diabetes in women with a history of gestational diabetes mellitus[J]. Diabetes Care, 2020, 43(4): 793-798.
[20] Panuganti PL, Hinkle SN, Rawal S, et al.Lactation duration and long-term thyroid function: A study among women with gestational diabetes[J]. Nutrients, 2018, 10(7): 938.
[21] Haile ZT, Chertok IRA, Chavan BB, et al.Combined influence of gestational diabetes and gestational weight gain on exclusive breastfeeding[J]. Breastfeed Med, 2019, 14(8): 538-550.
[22] Liu Q, Zhao J.Effects of single epidural injection of morphine in combination with intravenous injection of dezocine on analgesia after caesarean section and serum levels of 5-hydroxytryptamine and prolactin running title: Analgesia after cesarean section[J]. Rev Argent Clin Psic, 2020, 29(3): 305.
[23] 刘志雯,姚巧红.产后泌乳延迟的常见因素分析及护理对策[J].实用妇科内分泌电子杂志,2019,6(15):173, 176.
[24] Casey T, Sun H, Burgess HJ, et al.Delayed lactogenesis II is associated with lower sleep efficiency and greater variation in nightly sleep duration in the third trimester[J]. J Hum Lact, 2019, 35(4): 713-724.
[25] 江秀英. 早产儿母亲焦虑抑郁水平与其泌乳量的相关性研究[J].中国妇幼卫生杂志,2019,10(3):16-19.
[26] 刘君,刘敏,蒋盘华,等.中国产妇泌乳Ⅱ期启动延迟发生率及影响因素的系统评价[J]. 中华现代护理杂志, 2021, 27(10):1300-1305.
[27] 戴宁,邓孝陵.武汉市产妇产后1周内焦虑情绪发生情况及影响因素[J].华南预防医学,2020,46(3):281-283.