剖宫产后早期皮肤接触促进足月儿母乳喂养的Meta分析

Effects of early skin-to-skin contact after cesarean section on breast feeding in full-term infants:a Meta-analysis

目的评价剖宫产术后早期皮肤接触护理在足月儿母乳喂养中的应用效果。方法检索中国知网(CNKI)、万方数据库、维普数据库、Cochrane Library、PubMed、Web of Science、EMBASE、EBSCO,检索时间均从建库至2019年3月。对纳入文献进行质量评价,并使用RevMan 5.3进行Meta分析。结果共纳入9篇文献,总样本量为1329例。Meta分析结果显示,剖宫产后早期皮肤接触护理组的足月儿首次母乳喂养时间早于常规护理组[MD=-28.86,95%CI(-32.16,-25.57),P<0.00001],母乳喂养评分高于常规护理组[MD=2.12,95%CI(0.89,3.35),P=0.0007],生后1个月[RR=1.14,95%CI(1.03,1.26),P=0.01]及生后6周~6个月[RR=1.20,95%CI(1.11,1.29),P<0.00001]的母乳喂养率均高于常规护理组。剖宫产后早期皮肤接触是一项安全有效的护理方式,不会对新生儿的体温产生不良影响[MD=0.09,95%CI(-0.11,0.28),P=0.39]。结论剖宫产术后早期实施皮肤接触护理是安全可行的,可改善母乳喂养情况,缩短首次母乳喂养时间,提高母乳喂养评分,提高生后1个月及6周~6个月的母乳喂养率。

Objective To evaluate the effects of early skin-to-skin contact(SSC)after cesarean section in breast feeding among full-term infants.Methods Literatures were retrieved in Chinese National Knowledge Infrastructure(CNKI),WanFang Data and VIP,Cochrane Library,PubMed,Web of Science,EMBASE,EBSCO from building database to March 2019.Quality evaluation was used to literatures included and the RevMan 5.3 was used to Meta-analysis.Results A total of 9 literatures were included with 1329 for the total sample size.Meta-analysis showed that the time of breast feeding for the first time in the group of early SSC after cesarean section was earlier than that in routine nursing group[MD=-28.86,95%CI(-32.16,-25.57),P<0.00001],the score of breast feeding was higher than that in routine nursing group[MD=2.12,95%CI(0.89,3.35),P=0.0007],rates of breast feeding one month after birth[RR=1.14,95%CI(1.03,1.26),P=0.01]and from six weeks to six months after birth[RR=1.20,95%CI(1.11,1.29),P<0.00001]were higher than those in routine nursing group with statistical differences.Early SSC after cesarean section was a safe and effective nursing method which had no influence on temperatures of neonate[MD=0.09,95%CI(0.11,0.28),P=0.39].Conclusions Early SSC after cesarean section is safe and practicable which can improve breast feeding,shorten the time of breast feeding for the first time,increase the scores of breast feeding and the rates of breast feeding one month after birth and from six weeks to six months after birth.