分娩方式对婴儿母乳喂养率的影响

Study of impact on children breastfeeding rate at leaving hospital and 42 days in different delivery modes.

【目的】探讨不同分娩方式对分娩后及产褥期母乳喂养的影响，促进母乳喂养。【方法】自2004年6月起收集北京大学第一医院分娩新生儿802例，在生后2～5d时、42d回访时追踪其母乳喂养情况。【结果】分娩后婴儿早接触早吸吮的时间剖宫产、自然产、助产三组分别为（32．80±35．70）、（20．00±32．32）、（25．40±35．27）h，剖宫产组和阴道自然产组间差别有统计学意义（F=22．626，P=0．000）。剖宫产、自然产、助产三组分别有96．8％、97．0％、93．8％的母亲在分娩前希望母乳喂养，比较两两差异无统计学意义；但生后2～5d时三组纯母乳喂养率分别为37．6％、45．0％、38．5％，42d时分别为35．2％、44．6％、40．0％；而未母乳喂养的主要原因，都是奶水不足或未下奶；对两个时期的母乳喂养情况进行比较，剖宫产和阴道自然产两组间母乳喂养差别有统计学意义，阴道自然产婴儿的全母乳喂养率高于剖宫产组，其他组问差别无统计学意义。多变量因素分析中发现母亲年龄越小、早接触时问越早、住房面积越小及孕期有母乳喂养愿望的母亲其生后2～5d时、42d时的母乳喂养率越高。【结论】严格剖宫产指征，加强孕期母乳喂养的健康教育，宣传适龄生育的好处，鼓励及促进自然分娩。

[Objective] To study the influence on children breastfeeding rate in different delivery modes when they were in hospital after birth and at 42 days visits. [Methods] From July in 2004, 802 children who were born mature in our hospital have been collected, and also their mothers did not have pregnant complications. A follow-up study was given for them,with children＇s weight, height, and so on. Examination was done at 42 days visit. The mothers were surveyed with questionnaires including infants＂ breastfeeding. [Results] Early contact of cesarean section（CS）, spontaneous delivery（SD）, midwife-delivery（MD） three groups were （32.80 ±35.70）. （20.00 ± 32.32 ）. （ 25.40 ± 35.27 ） hours respectively,the difference between CS and SD was significant（F=22. 626, P= 0.00）. The rate of these three groups mothers who wanted to breastfeeding before delivery were 96.8% .97.0% .93.8%, but after delivery when they stayed in hospital, the breastfeeding rate only were 37.6% .45.0% .38.5%, and 35.2% .44.6% .40.0% when their infants were 42 days. The first reason why they didn＇t breastfeed was they hadn＇t enough breast milk. The breastfeeding rate difference between CS and SD both were significant at 2-5 days and 42 days. In multi--factors analysis, we find that the mothers＇ breastfeeding rate would be higher if they were younger, or their early contacting time was earlier, they were willing to breastfeed before delivery, they stayed in smaller house during puerperal period. [Conclusion] To be strictly controlled indicators of cesarean section,enhance the health education on breastfeeding in pregnancy period, publicize the advantages to women of pregnancy at appropriate age, increase spontaneous delivery rate and give women the health education about what should they do during pregnant period.