孕前人体质量指数及孕期体重增量与泌乳启动延迟的相关性研究

Correlations of pre-pregnancy body mass index and gestational weight gain with delayed onset of lactogenesis

目的探讨孕前人体质量指数(body mass index,BMI)和孕期体重增量(gestational weight gain,GWG)与泌乳启动延迟(delayed onset of lactogenesis,DOL)之间的关系,为早期采取干预措施预防DOL发生提供参考依据。方法应用现况研究设计方法,采用便利抽样法,选取2018年1月—4月在本院产科住院分娩的产妇240例为研究对象。产前收集产妇社会人口学特征和产科相关资料,产后对产妇每天随访1次(最长至产后1周),由专人负责记录泌乳启动时间,根据有无发生泌乳启动延迟分为两组,并分析其与孕前BMI、GWG的关系。结果产妇DOL发生率为28.33%(68/240);单因素分析显示,孕前BMI、GWG与泌乳启动延迟均存在相关性(均P<0.001);二元Logistic回归分析显示,孕前BMI、GWG、初产是DOL发生的危险因素。结论孕前BMI过高、GWG过多,泌乳启动延迟发生风险增加;初产妇更易发生DOL。护理人员应尽早识别DOL高危人群,重视孕期体重管理,加强宣教和指导,以减少和预防DOL的发生,提高产妇母乳喂养质量,促进母婴健康。

Objective To explore the correlations of pre-pregnancy body mass index(BMI)and gestational weight gain(GWG)with delayed onset of lactogenesis(DOL),providing references for early prevention of delayed onset of lactogenesis.Methods Using cross-sectional method and convenience sampling,240 puerperaes with hospital delivery of the obstetrics department at a general hospital in Shanghai were selected from January to April 2019.Timing of maternal perception of onset of lactogenesis was recorded,and the sociodemographic data and obstetric-related information were collected by reviewing medical records.Everyday follow-up was done for at least one-week.The participants were divided into two groups according to the presence of DOL.Correlations of pre-pregnancy BMI and GWG with DOL were analyzed.Results The incidence of DOL was 28.33%(68/240).Univariate analysis showed that pre-pregnancy BMI and gestational weight gain were associated with DOL(P<0.001).Logistic regression analysis showed that pre-pregnancy BMI,GWG and primipara were risk factors of DOL.Conclusions High pre-pregnancy and excessive GWG increase the risk incidence of DOL.Primiparas are more likely to encounter DOL.Professionals should identify the high-risk women of DOL as early as possible,and pay attention to weight management during pregnancy,strengthen education and guidance to reduce and prevent the DOL,so as to improve the maternal breastfeeding quality and promote maternal and children health.