新生儿早期基本保健技术对3月龄内婴儿母乳喂养及健康结局的影响  

Effects of early essential newborn care on breastfeeding and health outcomes of infants within 3 months of age

作　　者：李夏芸 张琳 巫琳漫 谭玲[3] 袁飞 郭遥 刘欣 徐韬[6] Li Xiayun;Zhang Lin;Wu Linman;Tan Ling;Yuan Fei;Guo Yao;Liu Xin;Xu Tao(Beijing Fengtai Maternal and Child Health Family Planning Service Center(Beijing Fengtai District Maternal and Child Health Hospital),Beijing 100068,China;Save the Children International(UK)Beijing Representative Office,Chengdu 610041,China;Sichuan Maternal and Child Health Hospital,Chengdu 610045,China;Mianyang Maternal and Child Health Family Planning Service Center,Mianyang 621000,China;Deyang Jingyang District Family Planning Service Center,Deyang 618000,China;National Center for Women and Children's Health,China CDC,Beijing 100081,China)

机构地区：[1]北京市丰台区妇幼保健计划生育服务中心(北京市丰台区妇幼保健院),100068 [2]国际救助儿童会(英国)北京代表处,成都610041 [3]四川省妇幼保健院科教部,成都610045 [4]绵阳市妇幼保健计划生育服务中心,621000 [5]德阳市旌阳区计划生育服务中心,618000 [6]中国疾病预防控制中心妇幼保健中心,北京100086

出　　处：《中华新生儿科杂志（中英文）》2022年第1期40-44,共5页Chinese Journal of Neonatology

基　　金：国际救助儿童会(英国)北京代表处新生儿基础保健项目(34400084)。

摘　　要：目的探讨新生儿早期基本保健(early essential newborn care,EENC)技术对3月龄内婴儿母乳喂养及健康指标的影响。方法选取四川省经济、医疗水平和文化习俗较接近的绵阳市和德阳市8所妇幼保健院进行前瞻性非随机分组对照试验研究,干预组和对照组分别包括1所市级妇幼保健院和3所县(区)级妇幼保健院。干预组开展EENC技术,对照组开展常规操作。采用方便抽样的方法,选择2017年9月至2018年9月分娩的新生儿及其母亲为研究对象,分别在分娩后、婴儿满1、3月龄时收集婴儿健康指标数据,包括喂养方式、脐带脱落时间、肺炎、败血症、腹泻等,比较两组婴儿健康结局。应用SPSS 22.0统计软件进行数据分析。结果干预组91.1%(278/305)的新生儿在停止皮肤接触前完成了首次母乳喂养,对照组为33.3%(36/108),差异有统计学意义(P<0.001)。干预组出院前纯母乳喂养率高于对照组[74.5%(228/306)比55.0%(177/322)],1月龄内转诊/因病住院发生率低于对照组[7.0%(19/272)比13.3%(37/278)],脐带脱落时间早于对照组[(8.3±2.9)d比(10.5±3.3)d],差异均有统计学意义(P<0.05);两组脐带感染、肺炎、腹泻发生率差异无统计学意义(P>0.05)。3月龄时干预组腹泻发生率高于对照组(P<0.05),两组肺炎和转诊/因病住院发生率差异无统计学意义(P>0.05)。两组均无发生败血症的病例。结论EENC可提高新生儿出院前纯母乳喂养率,降低1月龄婴儿转诊/因病住院发生率,缩短脐带脱落时间,且未造成更多的脐带感染。Objective To study the effects of early essential newborn care(EENC)on breastfeeding and health outcomes of infants within 3 months of age.Methods From September 2017 to September 2018,a prospective non-randomized controlled experimental study were carried out in 8 Women&Children's Hospital in Sichuan Province,including 1 municipal hospital and 3 county(district)hospitals as the intervention group and the other 1 municipal hospital and 3 county(district)hospitals as the control group.The intervention group received EENC and the control group received routine newborn care.Clinical data were collected after delivery and at the age of 1-and 3-month,including breastfeeding method,umbilical cord separation time,pneumonia,sepsis and diarrhea.Health outcome of the two groups were compared.The data were analyzed using SPSS 22.0.Results There are 91.1%(278/305)of the newborns in the intervention group completed their first breastfeeding before their first mother-baby skin contact,compared with 33.3%(36/108)in the control group(P<0.001).Exclusive breastfeeding rate before discharge in the intervention group was higher than the control group[74.5%(228/306)vs.55.0%(177/322),P<0.001].The incidences of re-hospitalization and referred to other hospitals due to illness was lower in intervention group than the control group within 1 month of age[7.0%(19/272)vs.13.3%(37/278),P=0.014];Umbilical cord separation time in the intervention group was earlier than the control group[(8.3±2.9)d vs.(10.5±3.3)d,P<0.001];No significant differences existed in the incidences of umbilical cord infection,pneumonia and diarrhea between the two groups(P>0.05).The incidence of diarrhea in intervention group was higher than that the control group at 3 months of age(P<0.05);No significant differences existed in the incidences of pneumonia and re-hospitalization and referred to other hospitals due to illness between the two groups(P>0.05).There was no sepsis case in the two groups.Conclusions EENC may improve exclusive breastfeeding rate before discha

关 键 词：新生儿保健 母乳喂养 婴儿健康 干预效果 

分 类 号：R174.4[医药卫生—妇幼卫生保健]