产后疲劳变化趋势及影响因素的前瞻性纵向研究

Prospective longitudinal study on the variation trend and influencing factors of postpartum fatigue

目的 探讨不同时期产后疲劳变化趋势及影响因素,为制定针对性产后疲劳管理提供参考依据。方法 采用便利抽样方法于2020年8-12月收集符合纳入标准产妇的一般资料,并分别于产后2 d、产后1周、产后2周、产后6周调查产后疲劳得分水平及变化趋势,并分析其影响因素。结果 本研究共纳入122例产妇,共105例完成4次随访并纳入最终研究,失访率为7.62%;产后6周内疲劳呈现“U”形变化趋势,其中体力疲劳、活动减少维度不同时期得分差异有统计学意义(P<0.05);产后出血量、婴儿啼哭、婴儿睡眠状况、伤口类型、参与照护婴儿程度、出生体质量、喂养方式分别进入了产后不同时期产后疲劳影响因素方程模型(F_(1)=3.626,F_(2)=2.324,F_(3)=2.619,F_(4)=3.900,P<0.05)。结论 产后6周内疲劳呈现“U”形变化趋势,且不同时期产后疲劳的影响因素不同,其中婴儿啼哭是产后6周内持续存在的危险因素,产后1周内主要是产妇自身因素所致疲劳(如产后出血量、伤口情况等),产后2周后疲劳的主要因素来自婴儿方面(如婴儿出生体质量、喂养方式),这提示母婴保健工作者应动态关注产后疲劳的变化趋势及其影响因素,采取针对性措施缓解其疲劳水平。

Objective To explore the variation trend and influencing factors of postpartum fatigue in different periods, and to provide a reference for formulating specific postpartum fatigue management.Methods This study was a prospective study design.General data of parturients meeting the inclusion criteria were collected by convenience sampling method from August 2020 to December 2020.Postpartum fatigue scores and their change trend were investigated at 2 days postpartum, 1 week postpartum, 2 weeks postpartum, and 6 weeks postpartum, respectively, and its influencing factors were analyzed.Results A total of 122 pregnant women were included in this study, and 105 cases were included after four follow-up visits, and the rate of lost follow-up was 7.62%.Fatigue within 6 weeks postpartum presented a U-shaped trend, and there were significant differences in the scores of physical fatigue and activity reduction at different periods(P<0.05).Postpartum blood loss, infant crying, infant sleep status, type of wound, degree of infant care participation, birth weight, and feeding mode were respectively included in the equation model of postpartum fatigue in different stages(F=3.626,F=2.324,F=2.619,F=3.900;P<0.05). Conclusion Fatigue within 6 weeks postpartum shows a U-shaped trend, and the influencing factors of postpartum fatigue are different in different periods.Among them, crying of infants is a persistent risk factor within 6 weeks postpartum, and fatigue within 1 week postpartum is mainly caused by maternal factors(such as postpartum blood loss, wound condition, etc.). The main factors of fatigue after 2 weeks postpartum are from the aspect of infants(such as birth weight and feeding mode),which suggests that maternal and infant health care workers should dynamically pay close attention to the trend of postpartum fatigue and its influencing factors, and take targeted measures to alleviate the fatigue level.