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  

Incidence and influencing factors of delayed onset of lactogenesisⅡin Chinese parturient women:a systematic review

作　　者：刘君[1] 刘敏[1] 蒋盘华[1] 陈慧娟[1] 胡珊珊[1] 付锦艳[2] Liu Jun;Liu Min;Jiang Panhua;Chen Huijuan;Hu Shanshan;Fu Jinyan(Department of Obstetrics,Wuxi Maternity and Child Health Hospital of Jiangsu Province,Wuxi 214002,China;Department of Nutrition,Wuxi Maternity and Child Health Hospital of Jiangsu Province,Wuxi 214002,China)

机构地区：[1]江苏省无锡市妇幼保健院产科,214002 [2]江苏省无锡市妇幼保健院营养科,214002

出　　处：《中华现代护理杂志》2021年第10期1300-1305,共6页Chinese Journal of Modern Nursing

基　　金：江苏省妇幼健康科研项目(F201841);无锡市卫生健康委妇幼健康科研项目(FYKY201701);无锡市首届“双百”中青年医疗卫生拔尖人才(BJ2020073)。

摘　　要：目的系统评价我国产妇泌乳Ⅱ期启动延迟(DOLⅡ)的发生率及影响因素,为相关研究和临床实践提供借鉴。方法计算机检索Web of Science、PubMed、Embse、Cochrane Library、维普、CNKI、万方和中国生物医学文献数据库中DOLⅡ发生率及影响因素的相关文献,2名研究者对文献进行质量评价及资料提取并进行系统评价;符合量性分析的资料使用Stata 12.0进行Meta分析。结果共13项研究纳入系统评价,Meta分析显示,我国产妇的DOLⅡ发生率为24%[95%置信区间为(18%~31%)]。主要影响因素中,产妇因素包括年龄、产次、分娩方式、身体质量指数、睡眠状况、妊娠期应激生活事件暴露、焦虑、抑郁、产后疲乏、妊娠合并症、麻醉方式、药物使用等,婴儿因素包括早产、出生体重、吸吮姿势、吸吮次数等,社会因素包括开奶时间、妊娠期母乳喂养教育等。结论我国产妇DOLⅡ发生率较高,涉及的影响因素较多,大部分因素的作用存有不同评价,与DOLⅡ的因果关系有待进一步验证。Objective To systematically evaluate the incidence and influencing factors of delayed onset of lactogenesisⅡ(DOLⅡ)in Chinese parturient women so as to provide a reference for related research and clinical practice.Methods We searched literature related to the incidence and influencing factors of DOLⅡin Web of Science,PubMed,Embase,Cochrane Library,VIP,China National Knowledge Infrastructure(CNKI),Wanfang Data and China Biology Medicine Literature Database by computer.Two researchers conducted the quality evaluation and data extraction on literature,as well as the systematic review.Meta-analysis was used for data conforming to quantitative analysis by Stata 12.0.Results A total of 13 studies were included in the systematic review.Meta-analysis showed that the incidence of DOLⅡin Chinese parturient women was 24%[95%confidence interval(18%-31%)].Among the main influencing factors,parturient women factors include age,parity,delivery method,body mass index,sleep status,exposure of stressful life events during pregnancy,anxiety,depression,postpartum fatigue,pregnancy complications,methods of anesthesia,drug use;infant factors involve premature delivery,birth weight,sucking posture,number of sucking;social factors consist of the time to milk,breastfeeding education during pregnancy.Conclusions The incidence of DOLⅡin Chinese parturient women is relatively high,and there are many influencing factors involved.The effects of most factors have different evaluations,and the causal relationship with DOLⅡneeds further verification.

关 键 词：META分析 系统评价 母乳喂养 泌乳Ⅱ期启动延迟 影响因素 

分 类 号：R174.4[医药卫生—妇幼卫生保健]