经阴道分娩女性泌乳启动延迟现状及影响因素分析  

Analysis of current status and influencing factors of lactation initiation delay in women with vaginal delivery

作　　者：董芳香 李丽 朱科华 张沙沙 关艳娜 韩静[4] 孟冉 陈茜[1] Dong Fangxiang;Li Li;Zhu Kehua;Zhang Shasha;Guan Yanna;Han Jing;Meng Ran;Chen Xi(Home-based Warm Delivery Room,Affiliated Hospital of Jining Medical College,Jining 272001,China;Obstetrics Outpatient Clinic,Affiliated Hospital of Jining Medical College,Jining 272001,China;Obstetrics Antenatal Ward,Affiliated Hospital of Jining Medical College,Jining 272001,China;Obstetrics Postpartum Ward,Affiliated Hospital of Jining Medical College,Jining 272001,China)

机构地区：[1]济宁医学院附属医院家庭化温馨产房,济宁272001 [2]济宁医学院附属医院产科门诊,济宁272001 [3]济宁医学院附属医院产科产前病区,济宁272001 [4]济宁医学院附属医院产科产后病区,济宁272001

出　　处：《中国实用护理杂志》2022年第19期1496-1502,共7页Chinese Journal of Practical Nursing

基　　金：济宁市科技发展计划项目(2020YXNS015);济宁医学院附属医院"苗圃"科研计划项目(MP-ZD-2020-004、MP-MS-2020-017)。

摘　　要：目的调查经阴道分娩女性泌乳启动延迟(DOL)情况及影响因素,为有效控制泌乳启动延迟、促进母乳喂养提供依据。方法采用便利抽样法,选取2020年11月6日至2021年1月16日在济宁医学院附属医院产科病区的住院产妇为研究对象,通过一般资料调查表、产妇分娩体验问卷(CEQ)等进行调查。采用二元Logistic回归分析确定DOL影响因素。结果622例经阴道分娩女性DOL发生率为38.75%(241/622);二元Logistic回归分析显示,年龄20~35岁、足月分娩、经产、采用分娩镇痛、经阴道分娩体验感受好是DOL的保护因素(OR值为0.012~0.868,均P<0.05);年龄>35岁、孕期增重过多、有妊娠期合并症、分娩时采用引产方式、产程时间长、分娩后会阴有损伤是DOL的危险因素(OR值为1.097~13.235,均P<0.05)。结论经阴道分娩女性DOL的发生率偏高且受多方面因素影响,对于高龄(年龄>35岁)、初产、妊娠期合并其他疾病、孕期增重过多、早产、产程时间长、未接受分娩镇痛、分娩时采用单一或联合引产方式、分娩中有会阴裂伤或会阴侧切、经阴道分娩体验差的人群应进行重点评估与防范。Objective To investigate cases of delayed lactation initiation in women with transvaginal delivery and the influencing factors,in order to provide a basis for effective control of delayed lactation initiation and promotion of breastfeeding.Methods Inpatients who were admitted to the obstetric ward of Affiliated Hospital of Jining Medical College from November 6,2020 to January 16,2021 were selected for the study using convenience sampling method and investigated by general information questionnaire and Chindbirth Experience Questionnaire(CEQ).Binary Logistic regression analysis was used to determine the factors influencing delayed lactation initiation.Results The incidence of delayed lactation initiation in 622 women with transvaginal delivery was 38.75%(241/622).Binary Logistic regression analysis showed that age 20-35 years,full-term delivery,labor and delivery,use of labor analgesia,and good experience of transvaginal delivery were protective factors for delayed lactation initiation(OR values were 0.012 to 0.868,all P<0.05);age>35 years,excessive weight gain during pregnancy,presence of pregnancy complications,use of induction of labor during delivery,long labor process,and damage to perineal skin after delivery were risk factors for delayed lactation initiation(OR values were 1.097 to 13.235,all P<0.05).Conclusions The high incidence of delayed lactation initiation in women with transvaginal delivery is influenced by a number of factors,which reminds the clinic that lactation in women after transvaginal delivery also needs to be taken into account,with priority assessment and prevention for those who are elderly(age≥35 years),primiparous,have other diseases during pregnancy,have gained too much weight during pregnancy,have preterm delivery,have a long duration of labor,have not received labor analgesia,have had a single or combined induction of labor,have had an episiotomy or perineal laceration during labor,and have a poor transvaginal delivery experience.

关 键 词：经阴道分娩 泌乳启动延迟 分娩体验 分娩质量 

分 类 号：R174.4[医药卫生—妇幼卫生保健]