北京市通州区产妇泌乳启动延迟发生情况及相关影响因素研究

doi:10.12183/j.scjpm.2022.0817

摘要/Abstract

摘要： 目的探讨北京市通州地区产妇泌乳启动延迟发生情况及相关影响因素,为提高母乳喂养率提供科学依据。方法以2019年3月至2021年2月在北京市通州区妇幼保健院分娩的产妇为研究对象,由经过统一培训并考核合格的护理人员随访其泌乳情况并通过问卷收集孕妇相关资料。采用描述性分析方法对产妇泌乳延迟发生情况进行分析,并采用单、多因素分析方法对泌乳延迟发生影响因素进行分析。结果共纳入2 109名产妇进行研究,产妇年龄20~48岁,以35~48岁居多,占54.10%。泌乳启动正常者1 387人,占65.8%,泌乳启动中位时间为50.65（19.33,70.14）h。泌乳启动延迟者722例,占34.2%。二分类Logistic回归分析结果显示,年龄≥35岁（OR=1.278）、孕期增重过多（OR=1.992）、初产妇（OR=1.243）、妊娠期糖尿病（OR=1.459）、妊娠期高血压疾病（OR=3.314）、剖宫产（OR=1.584）是产妇泌乳启动延迟发生的危险因素。结论北京市通州区产妇泌乳启动延迟发生率较高,高龄、孕期增重过多、初产妇、妊娠期糖尿病、妊娠期高血压疾病、剖宫产均是产妇泌乳启动延迟发生的危险因素,医护人员应当对于上述类型产妇予以重视,及时关注治疗,以期改善产妇泌乳启动延迟情况。

关键词: 产妇, 母乳喂养, 泌乳, 启动延迟, 影响因素

Abstract: Objective To explore the occurrence and related factors of delayed lactation initiation of parturients in Beijing, to provide a scientific basis for improving the breastfeeding rate. Methods The parturients who gave birth in Beijing Tongzhou Maternal and Child Health Hospital from March 2019 to February 2021 were selected as the research objects, their lactation status was followed up by nurses who had undergone unified training and passed the assessment, and the relevant data of pregnant women were collected through questionnaires. The descriptive analysis method was used to analyze the occurrence of delayed lactation, and univariate and multivariate analysis methods were used to analyze the influencing factors of delayed lactation. Results A total of 2 109 parturients were included in the study, aged 20-48 years old, and the proportion of 35-48 years old was higher, accounting for 54.10%. There were 1 387 parturients with normal initiation of lactation, accounting for 65.8%, and the median time of initiation of lactation was 50.65 （19.33, 70.14） h. There were 722 cases of delayed lactation initiation, accounting for 34.2%. The results of binary Logistic regression analysis showed that age ≥35 years old （OR=1.278）, excessive weight gain during pregnancy （OR=1.992）, primipara （OR=1.243）, gestational diabetes （OR=1.459）, gestational hypertension disease （OR=3.314）, and cesarean section （OR=1.584） were risk factors of delayed lactation initiation. Conclusion The incidence of delayed lactation initiation among parturients in the Tongzhou District of Beijing is relatively high. Advanced maternal age, excessive weight gain during pregnancy, primipara, gestational diabetes, gestational hypertension, and cesarean section are all risk factors for delayed lactation initiation. Medical staff should pay attention to the above-mentioned types of parturients and pay attention to treatment promptly, to improve the delayed lactation initiation of parturients.

Key words: Parturient, Breastfeeding, Lactation, Delayed initiation, Influencing factor

中图分类号:

R174

魏占超, 赵志玲, 孟彤, 叶琪, 万颖, 刘亚非. 北京市通州区产妇泌乳启动延迟发生情况及相关影响因素研究[J]. 华南预防医学, 2022, 48(7): 817-821.

WEI Zhan-chao, ZHAO Zhi-ling, MENG Tong, YE Qi, WAN Ying, LIU Ya-fei. Occurrence and related factors of delayed lactation initiation of parturients in Tongzhou District, Beijing[J]. South China Journal of Preventive Medicine, 2022, 48(7): 817-821.

参考文献

[1] Dubik SD, Amegah KE.Prevalence and determinants of early initiation of breastfeeding (EIBF) and prelacteal feeding in Northern Ghana: A cross-sectional survey[J]. PLoS One, 2021, 16(11): e0260347.
[2] Wu JL, Pang SQ, Jiang XM, et al.Gestational diabetes mellitus and risk of delayed onset of lactogenesis: A systematic review and meta-analysis[J]. Breastfeed Med, 2021, 16(5): 385-392.
[3] Parra M, Yang J, Weitner M, et al.Neonatal mice resist Plasmodium yoelii infection until exposed to para-aminobenzoic acid containing diet after weaning[J]. Sci Rep, 2021, 11(1): 90.
[4] Froh EB, Lee R, Spatz DL.The critical window of opportunity: Lactation initiation following cesarean birth[J]. Breastfeed Med, 2021, 16(3): 258-263.
[5] Gurung R, Sunny AK, Paudel P, et al.Predictors for timely initiation of breastfeeding after birth in the hospitals of Nepal- a prospective observational study[J].Int Breastfeed J,2021,16(1): 85.
[6] Sodeno M, Tappis H, Burnham G, et al.Associations between caesarean births and breastfeeding in the Middle East: A scoping review[J]. E Mediterr Health J, 2021, 27(9): 931-940.
[7] Rinaldini E, Verde Arbocco FC, Ezquer M, et al.Effect of thyromimetic GC-1 selective signaling on reproductive and lactational performance in the hypothyroid rat[J]. Eur Thyroid J, 2021, 10(5): 425-433.
[8] Farah E, Barger MK, Klima C, et al.Impaired lactation: Review of delayed lactogenesis and insufficient lactation[J].J Midwifery Womens Health, 2021 66(5):631-640.
[9] 王丽娜,孟珊,冉丽娟.产妇泌乳Ⅱ期延迟影响因素分析[J].现代医药卫生,2020,36(19):3079-3081.
[10] Moyo GPK, Hermann ND.Clinical characteristics of a group of cameroonian neonates with delayed breastfeeding initiation[J]. AJP, 2020, 6(3): 285-288.
[11] Pang WW, Hartmann PE.Initiation of human lactation: secretory differentiation and secretory activation[J]. J Mammary Gland Biol Neoplasia, 2007, 12(4): 211-221.
[12] Raihana S, Alam A, Chad N, et al.Delayed initiation of breastfeeding and role of mode and place of childbirth: Evidence from health surveys in 58 low-and middle-income countries (2012-2017)[J]. Int J Env Res Pub He, 2021, 18(11): 5976.
[13] Fadl N, Haile Z.Association between mode of delivery and breastfeeding practices in Egypt: Secondary analysis of Egypt Demographic and Health Survey[J]. East Mediterr Health J, 2021, 27(5): 474-82.
[14] Busch DW, Silbert-Flagg J.Breastfeeding plan of care for the late preterm infant from birth through discharge[J]. J Perinat Neonatal Nurs, 2021, 35(2): 169-76.
[15] Birhan TY, Seretew WS, Alene M.Trends and determinants of breastfeeding within one hour in Ethiopia, further analysis of Ethiopian Demographic and Health Survey: Multivariate decomposition analysis[J]. Ital J Pediatr, 2021, 47(1): 77.
[16] Tahsina T, Hossain AT, Ruysen H, et al.Immediate newborn care and breastfeeding: EN-BIRTH multi-country validation study[J]. BMC Pregnancy Childbirth, 2021, 21(Suppl 1): 237.
[17] Raihana S, Alam A, Huda T M, et al.Factors associated with delayed initiation of breastfeeding in health facilities:Secondary analysis of Bangladesh demographic and health survey 2014[J]. Int Breastfeed J, 2021, 16(1): 14.
[18] 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.
[19] Preusting I,Brumley J,Odibo L, et al.Obesity as a predictor of delayed lactogenesis II[J].Hum Lact, 2017,33(4) : 684-691.
[20] 李玉生,胡珊珊,刘君.妊娠期糖尿病产妇泌乳Ⅱ期启动延迟发生率及影响因素的系统评价[J].牡丹江医学院学报,2021,42(6):40-43,46.
[21] Nguefack F, Ngwanou DH, Moyo GPK, et al.Reasons for delayed breastfeeding initiation among newly delivered women in two first-category hospitals in Yaoundé, Cameroon[J]. OJPed, 2020, 10(3): 474-485.
[22] 丁佩佩,赵梅,张凤英,等.产妇妊娠晚期营养素摄入情况及Ⅱ期泌乳启动延迟影响因素分析[J].中国全科医学,2020,23(5):534-539.