2013年中国乳母下奶延迟流行状况及其影响因素  

Prevalence of and risk factors for delayed onset of lactation in Chinese lactating women in 2013

作　　者：姜珊[1] 段一凡[1] 庞学红[1] 毕烨[1] 王杰[1] 赵丽云[1] 荫士安[1] 杨振宇[1] 

机构地区：[1]中国疾病预防控制中心营养与健康所国家卫生与计划生育委员会微量元素重点实验室,北京100050

出　　处：《中华预防医学杂志》2016年第12期1061-1066,共6页Chinese Journal of Preventive Medicine

基　　金：国家卫生和计划生育委员会（原卫生部）医改重大项目[中国居民营养与健康状况监测（2013年）]志谢30个省、自治区、直辖市相关部门的大力支持;各省级工作队及55个监测点项目工作队的调查队员;广大调查对象的理解和支持;国家工作队全体工作人员的辛勤劳动

摘　　要：目的：研究中国乳母下奶延迟（下奶超过3d）的现状并分析其可能的影响因素。方法数据来源于2013年中国居民营养与健康状况监测中2岁以下儿童乳母的调查数据，采用多阶段分层整群抽样方法，抽取中国内地除西藏自治区以外的30个省（直辖市、自治区）的55个监测点，共调查目前哺乳或曾经哺乳过的乳母11178名。通过问卷调查收集乳母的基本信息、下奶时间、开奶时间、哺乳困难和母乳喂养知识等相关信息。采用国家统计局第六次人口普查的人口数据进行复杂抽样的加权处理，分析中国乳母下奶延迟率，同时采用多因素logistic回归模型分析其影响因素。结果11178名乳母中，3388名乳母下奶时间超过3 d，下奶延迟率为30.3%；经复杂加权后，中国乳母下奶延迟率为31.2%（95%CI：25.7%～36.8%）。剖宫产（OR=1.28,95%CI：1.06～1.53）、开奶时间≥4 h （OR=2.34,95%CI：1.76～3.11）是下奶延迟的不利因素；与大城市乳母相比，中小城市的乳母（OR=1.39,95%CI：1.05～1.84）发生下奶延迟的风险更高；与职业为家务的乳母相比，职业为企事业单位负责人（OR=0.68,95%CI：0.47～0.99）、服务业从业人员（OR=0.61,95%CI：0.43～0.86）、农林渔牧民（OR=0.65,95%CI：0.44～0.96）和待业（OR=0.64,95%CI：0.46～0.90）的乳母发生下奶延迟的风险较低（P〈0.05）。孕期接受过母乳喂养教育（OR=0.78,95%CI：0.62～0.98）下奶延迟的风险较低。结论我国乳母下奶延迟率较高，剖宫产、开奶时间晚是下奶延迟的主要危险因素，中小城市乳母和职业为家务的乳母是需要干预的重点人群，建议通过孕期母乳喂养知识教育降低下奶延迟率。Objective To study the prevalence of delayed onset of lactation （later than 3 days） in lactating women in China and to analyze its influencing factors. Methods Data were extracted from Chinese National Nutrition and Health Surveillance-Mothers, from mothers with children under 2 years of age （in 2013）. A total of 11 178 women who were lactating or had lactated were selected from 55 counties of 30 provinces （excluding the Tibet Autonomous Region） in China, using the multi-stage stratified cluster randomization sampling method. Basic information, including onset of lactation, initiation of breastfeeding, breastfeeding difficulties and breastfeeding knowledge were collected using a questionnaire investigation. The prevalence of delayed onset of lactation were analyzed by the weighted processing of complex sampling from the 6th national population census data. A multiple logistic regression was used to analyze the factors associated with delaged onset of lactation. Results Among 11 178 lactating women, 3 388 had an onset of lactation later than 3 d. The prevalence of delayed onset of lactation was 30.3%. After complex weighting, the prevalence of delayed onset of lactation was 31.2% （95%CI： 25.7%-36.8%） for lactating women in China. Delivery by Caesarean section （OR=1.28, 95%CI：1.06-1.53） and initiating breastfeeding≥4 h （OR= 〈br〉 2.34, 95%CI：1.76-3.11） were the negative factors for delayed onset of lactation. Compared with those living in large cities, lactating women living in medium or small cities （OR=1.39, 95%CI：1.05-1.84） had a higher risk of delayed onset of lactation. Compared with the lactating women doing housework, the risk of delayed onset of lactation was lower （P〈0.05） among those whose occupations were as leaders of Enterprises/Institutions （OR=0.68, 95%CI：0.47-0.99）, in catering and service trades （OR=0.61, 95%CI：0.43-0.86）, in agriculture/forestry/fishery/herdsmen fields （OR=0.65, 95%CI：0.44-0.96） and who were unemployed （OR=0.64, 95

关 键 词：泌乳障碍 母乳喂养 横断面研究 乳母 影响因素 

分 类 号：R174.4[医药卫生—妇幼卫生保健]