产后家庭访视对母乳喂养影响的Meta分析

Effect of postpartum home visit on breastfeeding:a Meta-analysis

目的系统评价产后家庭访视对母乳喂养的影响。方法应用计算机检索PubMed、EMbase、Cochrane Library、Web of Science、中国知网(CNKI)、VIP、中国生物医学文献数据库(CBM)和万方数据库,辅以手工检索,收集有关产后家庭访视对母乳喂养影响的随机对照试验(RCTs),检索时间均为建库至2019年3月。两名研究人员按照纳入和排除标准独立筛选文献、提取资料,使用Cochrane偏倚风险评价工具评价纳入研究的偏倚风险,使用Rev Man 5.3软件进行Meta分析。结果共纳入12项研究,包括4 037名研究对象。Meta分析显示:产后家庭访视可提高纯母乳喂养率(RR=1.70,95%CI:1.44~2.02,P<0.001)、母乳喂养知识知晓率(RR=1.19,95%CI:1.09~1.29,P <0.001)、母乳喂养技能掌握率(RR=1.09,95%CI:1.03~1.14,P<0.01)。结论基于现有证据,产后家庭访视可有效提高母乳喂养知识知晓率和技能掌握率,进而提高纯母乳喂养率。为便于临床推广使用,未来研究应聚焦于标准化家庭访视流程及内容体系的探索。

Objective To systematically review the effect of postpartum home visit on breastfeeding.Methods A computer was used to search PubMed,EMbase,Cochrane Library,Web of Science,CNKI,VIP,CBM,and Wanfang Database,combining with manual retrieval,randomized controlled trials(RCTs)about the effect of postpartum home visit on breastfeeding were collected,the retrieval time was from building database to March 2019.Two reviewers independently screened literatures,extracted the data according to inclusion criteria and exclusion criteria,Cochrane bias risk assessment tool was used to evaluate the bias risk,Rev Man 5.3 software was used for Meta analysis.Results A total of 12 studies(4037 participants)were included.Meta analysis showed that postpartum home visit can improve exclusive breastfeeding rate(RR=1.70,95%CI:1.44-2.02,P<0.001),awareness rate of breastfeeding knowledge(RR=1.19,95%CI:1.09-1.29,P<0.001),mastery rate of breastfeeding skills(RR=1.09,95%CI:1.03-1.14,P<0.01).Conclusion Based on the available evidence,postpartum home visit can effectively improve awareness rate of breastfeeding knowledge and mastery rate of breastfeeding skills,further improve exclusive breastfeeding rate,future research should focus on standardization of family visit process and content system for facilitating clinical application.