重症监护病房住院产妇母乳喂养的影响因素  

Factors influencing breastfeeding in parturients admitted to intensive care unit

作　　者：周冬[1] 肖梅[1] 赵蕾[1] 甘泉 Zhou Dong;Xiao Mei;Zhao Lei;Gan Quan(Department of Obstetrics,Maternal and Child Health Hospital of Hubei Province,Wuhan 430070 China;Department of Critical Care Medicine Maternal and Child Health Hospital of Hubei Province Wuhan 430070,China)

机构地区：[1]湖北省妇幼保健院产科,武汉430070 [2]湖北省妇幼保健院重症医学科,武汉430070

出　　处：《中华围产医学杂志》2022年第7期519-525,共7页Chinese Journal of Perinatal Medicine

基　　金：中国疾病预防控制中心妇幼保健中心“母婴营养与健康研究项目”(2019FYH006);武汉中青年医学骨干人才培养工程(第八批);湖北省卫生和计划生育委员会科研基金项目(WJ2018H0159)。

摘　　要：目的分析重症监护病房(intensive care unit,ICU)住院产妇母乳喂养的影响因素。方法本研究为现况调查,研究对象为2020年3月1日至8月31日在湖北省妇幼保健院重症医学科住院的产妇。通过电子病历系统收集产妇的分娩信息及收住ICU的原因;产后第3~7天进行母乳喂养自我效能量表(Breastfeeding Self-Efficacy Scale,BSES)、情绪调节量表(Emotion Regulation Scale,ERS)和爱丁堡产后抑郁量表(Edinburgh Postnatal Depression Scale,EPDS)评分;产后半年通过问卷星获取产妇的基本情况、母乳喂养知识来源和母乳喂养信息。采用t检验、秩和检验、χ^(2)检验(或校正χ^(2)检验,或Fisher精确概率法)及趋势检验及二分类logistic回归分析等方法进行统计学分析。结果共138例产妇纳入分析,包括母乳喂养组117例(母乳喂养≥6个月67例,母乳喂养<6个月50例)和人工喂养组21例。母乳喂养组与人工喂养组比较,产后食欲好[2组"一般""较好"和"非常好"分别为21.4%(25/117)、59.8%(70/117)和18.8%(22/117)与85.7%(18/21)、14.3%(3/21)和0.0%(0/21),χ^(2)=27.29]、每天睡眠时间充足[指睡眠≥6 h,87.2%(102/117)与57.2%(12/21),χ^(2)=10.99]、BSES评分高[107.00分(92.00~122.00分)与55.00分(50.00~68.50分),Z=6.41]、ERS评分高[52.00分(45.50~59.00分)与38.00分(27.05~42.50分),Z=5.05]、产妇通过医院知识宣教[59.0%(69/117)与4.8%(1/21),χ^(2)=18.82]和自学途径[62.4%(73/117)与33.3%(7/21),χ^(2)=6.17]获取母乳喂养知识者的比例更高,产后出血[18.8%(22/117)与42.9%(9/21),χ^(2)=5.91]、妊娠合并心脏病[5.1%(6/117)与23.8%(5/21),χ^(2)=8.47]及EPDS评分≥13分[13.7%(16/117)与61.9%(13/21),χ^(2)=24.95]的比例更低(P值均<0.05)。与母乳喂养<6个月组比较,母乳喂养≥6个月组产后食欲好[2组"一般""较好"和"非常好"分别为7.5%(5/67)、68.7%(46/67)和23.9%(16/67)与40.0%(20/50)、48.0%(24/50)和12.0%(6/50),χ^(2)=13.96]、每天睡眠时间充足[94.0%(63/67)与78%(39/50),χ^(2)=6.57Objective To investigate and analyze the factors influencing breastfeeding in parturients admitted to intensive care unit(ICU).Methods A cross-sectional survey was conducted on parturients from the ICU of Maternal and Child Health Hospital of Hubei Province from March 1 to August 31,2020,whose delivery information and reasons for ICU admission were retrieved from the electronic medical record system.Breastfeeding Self-Efficacy Scale(BSES),Emotion Regulation Scale(ERS),and Edinburgh Postnatal Depression Scale(EPDS)scores were assessed between postpartum day 3-7.Half a year after delivery,basic information about the parturients,sources of available breastfeeding knowledge,and breastfeeding data were surveyed through Wenjuanxing,an online questionnaire platform.Wilcoxon test,t-test,Chi-square test(or calibration Chi-square,or Fisher's exact test),trend test,and binary logistic regression were adopted for statistical analysis.Results A total of 138 parturients were enrolled and divided into the breastfeeding group(n=117)and bottle-feeding group(n=21).Both mixed feeding and exclusive breastfeeding women were eligible for the breastfeeding group,which were further classified as subgroup A(breastfeeding≥6 months,n=67)and subgroup B(breastfeeding<6 months,n=50).A higher breastfeeding rate was observed in parturients with good or excellent postpartum appetite["average","good"and"excellent"in both groups were 21.4%(25/117),59.8%(70/117)and 18.8%(22/117)vs 85.7%(18/21),14.3%(3/21)and 0.0%(0/21),χ^(2)=27.29],adequate daily sleep[defined as≥6 hours per day,87.2%(102/117)vs 57.2%(12/21),χ^(2)=10.99],higher BSES[107.00(92.00-122.00)vs 55.00(50.00-68.50),Z=6.41],and ERS score[52.00(45.50-59.00)vs 38.00(27.05-42.50),Z=5.05],and access to breastfeeding knowledge through hospital education[59.0%(69/117)vs 4.8%(1/21),χ^(2)=18.82]and self-study[62.4%(73/117)vs 33.3%(7/21),χ^(2)=6.17](all P<0.05).At the same time,those who had postpartum hemorrhage[18.8%(22/117)vs 42.9%(9/21),χ^(2)=5.91],pregnancy complicated by heart disease

关 键 词：母乳喂养 自我效能 情绪调节 抑郁症 产后 影响因素分析 

分 类 号：R174.4[医药卫生—妇幼卫生保健]