三种不同分娩方式对初产妇母乳喂养情况的影响  

Effects of three different modes of delivery on primipara breastfeeding

作　　者：郑儿 包晓琴 张莉 ZHENG Er;Bao Xiao-qin;Zhang Li(Department of Obstetrics and Gynecology,Tonglu Maternity and Child Healthcare Hospital,Tonglu 311500,China)

机构地区：[1]桐庐县妇幼保健院妇产科

出　　处：《健康研究》2019年第4期405-408,共4页Health Research

摘　　要：目的探讨阴道自然分娩、无痛分娩和剖宫产对初产妇母乳喂养情况的影响。方法选取在我院产科成功分娩的初产妇280例,其中阴道自然分娩102例、无痛分娩83例和剖宫产95例;观察比较各组产妇的母乳喂养情况,包括泌乳始动时间、泌乳量和出院时纯母乳喂养比率,比较各组产妇的母乳喂养自我效能(BSES-SF)评分、入院时及产后24h、48h的血清催乳素(PRL)水平及新生儿出生4d时的体质量。结果三组产妇的泌乳始动时间、出院时纯母乳喂养比率、48h泌乳充足比率、BSES-SF评分比较,阴道自然分娩组和无痛分娩组产妇均较剖宫产组有显著优势,差异均有统计学意义(P<0.05);三组产妇的24h泌乳充足比率和新生儿出生4d时体质量下降≥10%比率,差异均无统计学意义(P>0.05)。入院时,三组产妇的血清PRL水平差异无统计学意义(P>0.05);产后24 h和48 h,阴道自然分娩组和无痛分娩组产妇的血清PRL水平均高于剖宫产组,差异有统计学意义(P<0.05)。结论与剖宫产相比,经阴道自然分娩及无痛分娩可显著提高产妇产后的泌乳功能、母乳喂养自我效能及PRL水平,提高母乳喂养成功率,有利于新生儿的生长发育。Objective To evaluate the effects of vaginal delivery,painless delivery and cesarean section on primipara breastfeeding.Methods Firstly,280 primiparas with successful delivery in our hospital were chosen as the subjects of study and divided into three groups,namely,group A(n=102,made up of those subjected to vaginal delivery),group B(n=83,made up of those subjected to painless delivery),and group C(n=95,made up of those subjected to cesarean section).Secondly,the breast milk feeding status of each group was observed and compared in terms of initial time of lactation,lactation yield and rate of exclusive breastfeeding at discharge.Lastly,the self-efficacy of breastfeeding,the BSES-SF scores,the serum prolactin(PRL)level at admission and 24 h/48 h after delivery,and the changes in body weight at 4 d after birth in each group were compared.Results Group A and group B were found to do better in lactation initiation time,the rate of exclusive breastfeeding at discharge,the 48 h lactation adequacy ratio,and the BSES-SF scores.The differences were statistically significant(P<0.05).No significant difference was found between the three groups in the ratio of 24 h lactation adequacy and the ratio of the weight loss over 10%of newborns at 4 days in the three groups(P>0.05).No statistically significant difference was found between the three groups in serum PRL levels observed at admission(P>0.05).However,the serum PRL levels of group A and group B as observed at 24 h and 48 h after birth both were significantly higher than that of group C(P<0.05).Conclusions Compared to cesarean section,vaginal delivery and painless delivery can significantly improve postpartum lactation function,breast feeding self-efficacy and PRL level,improve the success rate of breast feeding,and thus significantly facilitate the growth and development of the newborns.

关 键 词：初产妇 分娩方式 母乳喂养 血清催乳素 

分 类 号：R714.3[医药卫生—妇产科学]