早产儿母亲泌乳Ⅱ期启动时间与产后早期泌乳量的相关性研究

Correlation between the onset time of lactation period Ⅱ and lactation yield of the early stage after delivery in preterm＇s mothers

目的 通过连续测定新生儿重症监护病房（NICU）住院早产儿母亲产后早期泌乳量及其泌乳Ⅱ期启动时间,分析、探讨泌乳Ⅱ期启动时间与产后早期泌乳量的相关关系.方法 对山东省某三级甲等综合医院产科住院分娩的100例早产产妇进行产后泌乳量跟踪测定并详细记录泌乳Ⅱ期启动时间,采用早产儿母亲泌乳相关因素综合问卷及爱丁堡产后抑郁量表（EPDS）对泌乳Ⅱ期启动延迟的相关因素进行调查.结果 NICU住院早产儿母亲平均泌乳Ⅱ期启动时间为（68.23±26.42） h,泌乳Ⅱ期启动延迟发生率为36%（36/100）;泌乳Ⅱ期启动时间与产后14 d泌乳量呈负相关关系（r=-0.525--0.354,P〈0.01）;泌乳Ⅱ期启动延迟组产后14 d泌乳量均低于非延迟组（Z=-4.89--3.10,P〈0.01）;是否合并妊娠高血压综合征（以下简称妊高症）（OR=4.589,P〈0.01）、 睡眠时间（OR=0.649,P〈0.05）、 开奶时间（OR=1.120, P〈0.01）是泌乳Ⅱ期启动延迟的影响因素.结论 NICU住院早产儿母亲泌乳Ⅱ期启动延迟发生率高;泌乳Ⅱ期启动延迟影响NICU住院早产儿母亲产后早期泌乳量;医护工作者应重视泌乳Ⅱ期启动时间,及时纠正妊高症、增加产妇睡眠时间、尽早开奶,以减少和预防泌乳Ⅱ期启动延迟的发生,改善早产产妇泌乳状况.

Objective To analyze and explore the correlation between the onset time of lactogenesisⅡ and lactation yield of the early stage after delivery in preterm＇s mothers by continuously determining the lactation yield of the early stage after delivery in hospitalized preterm＇s mothers and the onset time of lactogenesisⅡin neonatal intensive care unit （NICU）. Methods We measured lactation yield and recorded the onset time of lactogenesis Ⅱ from 100 premature labour puerpera with hospital delivery of Obstetrics Department at a class Ⅲgrade A general hospital in Shandong Province. The relative factors of delayed onset of lactogenesis Ⅱ （DOL Ⅱ） were investigated with the preterm＇s mothers lactation-related factors comprehensive questionnaire and the Edinburgh Postnatal Depression Scale （EPDS）. Results The mean onset time of lactogenesis Ⅱ of hospitalized preterm＇s mothers in NICU were （68.23±26.42） hours. The incidence of DOL Ⅱ was 36% （36/100）. The onset time of lactogenesis Ⅱwas negatively related to the lactation yield 14 days after delivery （r=-0.525--0.354, P〈0.01）. The lactation yield 14 days after delivery of onset delay group of lactogenesis Ⅱ was less than that of non-delayed group （Z=-4.89--3.10, P〈0.01）. The influencing factors of DOL Ⅱ included whether they were combined with pregnancy-induced hypertension syndrome （OR=4.589, P〈 0.01）, hours of sleep （OR=0.649, P〈0.01） and the first breast-feeding （OR=1.120, P〈0.01）. Conclusions The incidence of DOL Ⅱ is high in hospitalized preterm＇s mothers of NICU.The DOL Ⅱ affects the lactation yield of the early stage after delivery in preterm＇s mothers. Medical workers should pay attention to the onset time of lactogenesis Ⅱ, correct pregnancy-induced hypertension syndrome in time, increase hours of sleep of puerpera and promote the first breast-feeding early enough so as to reduce or prevent the DOL Ⅱand to improve the lactation condition of premature labour puerpera.