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护理学报 ›› 2021, Vol. 28 ›› Issue (7): 49-52.doi: 10.16460/j.issn1008-9969.2021.07.049

• 调查研究 • 上一篇    下一篇

229例产科监护室高危妊娠产妇泌乳启动延迟现状及影响因素分析

谢晓星1,2, 赵敏慧1   

  1. 1.同济大学附属第一妇婴保健院 护理部,上海 200000;
    2.宁波市妇女儿童医院 产科监护室,浙江 宁波 315010
  • 收稿日期:2020-06-05 出版日期:2021-04-10 发布日期:2021-05-12
  • 通讯作者: 赵敏慧(1973-),女,上海人,硕士,副主任护师。E-mail:18939915592@163.com
  • 作者简介:谢晓星(1989-),女,浙江温州人,本科学历,硕士研究生在读,主管护师。

Current Status of Delayed Onset of Lactogenesis II of High-risk Pregnant Women in Maternal Intensive Care Unit and Its Influence Factors: A 229-case Study

XIE Xiao-xing1,2, ZHAO Min-hui1   

  1. 1. Dept. of Nursing Administration, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai 200000, China;
    2. Maternal Intensive Care Unit, Ningbo Women and Children’s Hospital, Ningbo 315010, China
  • Received:2020-06-05 Online:2021-04-10 Published:2021-05-12

摘要: 目的 调查产科监护室高危妊娠产妇泌乳Ⅱ期启动延迟现状,并分析其影响因素。方法 采用便利抽样方法,选取2019年5—10月浙江省某三级甲等母婴专科医院分娩后入住产科监护室的229例高危妊娠产妇作为研究对象。采用一般资料调查表、泌乳日志、爱丁堡产后抑郁量表及中文版疲乏评定量表对其进行调查。采用二分类Logistic回归分析产科监护室高危妊娠产妇泌乳启动延迟的影响因素。结果 229例产科监护室高危妊娠产妇发生泌乳启动延迟97例,发生率为42.4%;二分类Logistic回归分析结果显示,年龄≥35岁(OR=2.523,P=0.003)、有妊娠期高血压病(OR=2.523,P=0.003)、开奶时间晚(OR=0.924,P=0.025)是产科监护室高危妊娠产妇泌乳启动延迟的危险因素。结论 产科监护室高危妊娠产妇泌乳启动延迟率较高,尤其应关注年龄≥35岁、有妊娠期高血压疾病、开奶时间晚的高危妊娠产妇,建议做好孕期保健及健康教育,加强泌乳干预,促进营养吸收,增加产妇泌乳知识,以降低泌乳启动延迟率。

关键词: 产科监护室, 高危妊娠, 产妇, 泌乳启动延迟

Abstract: Objective To investigate the status quo of delayed onset of lactogenesis Ⅱ(DOL Ⅱ) and its influence factors of high-risk pregnant women in maternal intensive care unit (MICU). Methods Totally 229 parturients admitted to MICU immediately after termination of pregnancy in a tertiary grade-A maternal and child healthcare hospital in Zhejiang Province from May to October 2019 were selected by convenient sampling method. General information questionnaire, lactation log, the Edinburgh Postpartum Depression Scale (EPDS) and the Chinese version of the Fatigue Rating Scale (FS-14) were used to investigate the influence factors of DOL Ⅱ and binary logistic regression analysis was performed for data analysis. Results Of the total, 97 cases suffered DOL Ⅱ, with an incidence of 42.4%. Binary logistic regression analysis showed that aged ≥35 (OR=2.523, P=0.003), with hypertensive disease during pregnancy (OR=2.523, P=0.003), and late secretion of colostrums (OR=0.924, P=0.025) were risk factors for DOL Ⅱ. Conclusion High-risk pregnant women in MICU have a higher rate of DOL Ⅱ. Special attention should be paid to high-risk pregnant women aged ≥35 years, those with hypertensive disease during pregnancy, and those with late secretion of colostrums. Pregnancy healthcare and health education, lactation intervention, nutrient absorption, and maternal lactation knowledge are beneficial to reducing the rate of DOL Ⅱ.

Key words: maternal intensive care unit, high-risk parturient, parturient, delayed onset of lactogenesis Ⅱ

中图分类号: 

  • R473.71
[1] Neville MC, Morton J.Physiology and Endocrine Changes underlying Human Lactogenesis II[J]. Nutr, 2001,131(11): 3005-3008. DOI:10.1038/sj.ijo.0801799.
[2] Nommsen-Rivers LA, Chantry CJ, Peerson JM, et al.Delayed Onset of Lactogenesis among First-time Mothers Is Related to Maternal Obesity and Factors Associated with Ineffective Breastfeeding[J]. Am J Clin Nutr, 2010,92(3): 574-584. DOI:10.3945/ajcn.2010.29192.
[3] Haile ZT, Chavan BB, Teweldeberhan A, et al.Association Between Gestational Weight Gain and Delayed Onset of Lactation: The Moderating Effects of Race/Ethnicity[J]. Breastfeeding Med, 2017, 12(2):79-85. DOI:10.1089/bfm.2016.0134.
[4] 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.DOI:10.12114/j.issn.1007-9572.2020.00.105.
[5] 吴祝凤,徐琼,杨楠楠,等.产后泌乳启动延迟的现状及其干预措施分析[J].护理学报,2018,25(1):30-34.DOI:10.16460/j.issn1008-9969.2018.01.034.
[6] Vanderlaan J, Dunlop A, Rochat R, et al.Methodology for Sampling Women at High Maternal Risk in Administrative Data[J]. BMC Pregnancy Childbirth,2019,19(1):364. DOI:10.1186/s12884-019-2500-7.
[7] 朱旭红,姜李媛.2015—2017年妊娠高危因素变化情况及分级分层管理应用分析[J].中国全科医学, 2019,22(26):3217-3221. DOI:10.12114/j.issn.1007-9572.2019.00.071.
[8] 任钰雯,高海凤.母乳喂养理论与实践[M].北京:人民卫生出版社,2018:12.
[9] Cox JL, Holden JM, Sagovsky R.Detection of Postnatal Depression. Development of The 10-item Edinburgh Postnatal Depression Scale[J].Br J Psychiatry, 1987(150):782-786. DOI:10.1192/bjp.150.6.782.
[10] Lee DT, Yip SK, Chiu HF, et al.Detecting Postnatal Depression in Chinese Women.Validation of the Chinese Version of the Edinburgh Postnatal Depression Scale[J]. Br J Psychiatry, 1998, 172:433-437.DOI:10.1192/bjp.172.5.433.
[11] Liu ZH, He ST, Deng CM, et al.Neuraxial Labour Analgesia Is Associated with a Reduced Risk of Maternal Depres-sion at 2 Years after Childbirth: A Multicentre, Prospective, Longitudinal Study[J]. Eur J Anaesthesiol, 2019, 36(10):745-754. DOI:10.1097/EJA.0000000000001058.
[12] Chalder T, Berelowitz G, Pawlikowska T, et al.Development of a Fatigue Scale[J]. J Psychosom Res, 1993, 37(2):147-153. DOI:10.1016/0022-3999(93)90081-p.
[13] 王天芳,张翠珍,刘雁峰.慢性疲劳综合征病人的疲劳、抑郁、焦虑与生活事件的特点及其相关性分析[J].中国行为医学科学,2000, 9(2):84.DOI:10.3760/cma.j.issn.1674-6554.2000.02.002.
[14] 栾丹丹,于秀荣,蔺香云.早产儿母亲泌乳Ⅱ期启动时间与产后早期泌乳量的相关性研究[J]. 中华现代护理杂志,2018,(8):874-879.DOI:10.3760/cma.j.issn.1674-2907.2018.08.002.
[15] Yu X, Li J, Lin X,et al.Association between Delayed Lactogenesis Ⅱ and Early Milk Volume among Mothers of Preterm Infants[J]. Asian Nurs Res (Korean Soc Nurs Sci),2019,13(2):93-98.DOI:10.1016/j.anr.2019.02.001.
[16] 袁水琴,李秋芳,徐鑫芬.早产儿母亲泌乳启动延迟影响因素的研究进展[J].中国护理管理,2019,19(8):1244-1247.DOI:10.3969/j.issn.1672-1756.2019.08.027.
[17] 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.DOI:10.1177/0890334419835174.
[18] 袁梦梅,曾铁英,代玲,等.女性分娩恐惧真实体验质性研究的系统评价[J].护理学杂志,2019,34(15):69-73.DOI:10.3870/j.issn.1001-4152.2019.15.069.
[19] Vigil-De Gracia P, Ramirez R, Durán Y, et al. Magnesium Sulfate for 6 vs 24 Hours post Delivery in Patients who Received Magnesium Sulfate for Less Than 8 Hours Before Birth: A Randomized Clinical Trial[J]. BMC Pregnancy Childbirth,2017,17(1):241.DOI:10.1186/s12884-017-1424-3.
[20] Liu Y, Yao J, Liu X, et al.A Randomized Interventional Study to Promote Milk Secretion during Mother-baby Separation based on the Health Belief Model: A Consort Compliant[J]. Medicine (Baltimore), 2018, 97(42):e12921. DOI:10.1097/MD.0000000000012921.
[21] Motiang M.Obstetric Patients Admitted to the Intensive Care Unit of Dr George Mukhari Academic Hospital,Ga-Rankuwa, South Africa[J].SAJCC, 2017,33(1):12-14. DOI:10.7196/SAJCC.2017.v33i1.279.
[22] Hinton L, Locock L, Knight M.Maternal Critical Care:What Can We Learn from Patient Experience?A qualitative Study[J]. BMJ Open,2015,5(4):e006676. DOI:10.1136/bmjopen-2014-006676.
[23] 龚妹,郑九生.规范围生期保健对子痫前期妊娠结局的影响[J].中国妇幼保健,2020,35(4):630-633. DOI:10.19829/j.zgfybj.issn.1001-4411.2020.04.015.
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