二胎产妇住院期间纯母乳喂养现状调查及影响因素的Logistic回归分析

Investigation on the Current Situation of Exclusive Breastfeeding during the Hospitalization of Second-Child Parturients and Logistic Regression Analysis of the Influencing Factors

目的:调查二胎产妇住院期间纯母乳喂养现状,并以单因素及多因素Logistic回归分析纯母乳喂养的影响因素。方法:选取2020年5~10月期间在西北妇女儿童医院妇产科住院分娩的600例二胎产妇,自行设计问卷调查其喂养方式和母乳喂养知识掌握情况,采用中文版母乳喂养态度量表评估产妇的母乳喂养态度。根据实际喂养方式将600例二胎产妇分为纯母乳喂养组和非纯母乳喂养组,以单因素及多因素Logistic回归分析纯母乳喂养的影响因素。结果:600例二胎产妇中,纯母乳喂养组470例,非纯母乳喂养组130例,纯母乳喂养占比为78.33%;423例二胎产妇母乳喂养知识评分>20分,母乳喂养知识掌握率为70.50%;253例为积极母乳喂养态度,积极母乳喂养态度的二胎产妇占比42.17%。单因素分析结果显示,纯母乳喂养组新生儿每天吸吮次数>8次、一胎主要为纯母乳喂养、大专及以上文化程度、家庭平均月收入>6000元、掌握母乳喂养知识、积极母乳喂养态度的产妇比例高于非纯母乳喂养组(P<0.05),而剖宫产、乳头凹陷、乳汁分泌不足的产妇比例低于非纯母乳喂养组(P<0.05)。多因素Logistic回归分析结果显示,剖宫产、乳头凹陷、乳汁分泌不足、新生儿每天吸吮次数≤8次、一胎主要为非纯母乳喂养、中专(高中)及以下文化程度、家庭平均月收入≤6000元、未掌握母乳喂养知识、非积极母乳喂养态度均是二胎产妇住院期间纯母乳喂养的不利影响因素(P<0.05)。结论:二胎产妇住院期间纯母乳喂养现状处于中等偏上水平,其影响因素包括分娩方式、乳头凹陷、乳汁分泌情况等,临床应结合相关影响因素针对性干预以提高产妇纯母乳喂养率。

Objective:To investigate the current situation of exclusive breastfeeding during the hospitalization of second-child parturients,and to analyze the influencing factors of exclusive breastfeeding by Logistic regression.Methods:A total of 600 second birth parturient who were hospitalized in the department of Obstetrics and Gynecology of Northwest Women's and Children's Hospital from May to October 2020 were selected.A self-designed questionnaire was used to investigate their feeding methods and knowledge of breastfeeding,and the Chinese breastfeeding attitude scale was used to evaluate the maternal breastfeeding attitude.According to the actual feeding methods,600 second-child parturients were divided into exclusive breastfeeding group and non exclusive breastfeeding group.The influencing factors of exclusive breastfeeding were analyzed by single and multivariate Logistic regression.Results:Among the 600 cases of second birth parturient,470 cases were in the exclusive breastfeeding group,and 130 cases in the non exclusive breastfeeding group,the incidence of exclusive breastfeeding was 78.33%.The score of breastfeeding knowledge of 423 parturients with second child was more than 20,and the knowledge mastery rate of breastfeeding was 70.50%.253 cases had positive breastfeeding attitude,and 42.17%of second-child parturients had positive breast-feeding attitude.The results of univariate analysis showed that the proportion of newborns with suckling times>8 times per day,one child mainly with exclusive breastfeeding,college education or above,average monthly family income>6000 yuan,master knowledge of breastfeeding and positive attitude towards breastfeeding in the exclusive breastfeeding group were higher than those in the non exclusive breastfeeding group(P<0.05),while the proportion of cesarean section,crater nipple and insufficient milk secretion were lower than those in non exclusive breastfeeding group(P<0.05).Multivariate Logistic regression analysis showed that cesarean section,crater nipple and insufficient milk secretion,newborns with suckling times≤8 times per day,one child mainly with non exclusive breastfeeding,technical secondary school(high school)and the following cultural level,average monthly family income≤6000 yuan,no master knowledge of breastfeeding,no positive attitude towards breastfeeding were adverse influence factors of exclusive breastfeeding during hospitalization of second birth parturient (P<0.05).Conclusion:The current situation of exclusive breastfeeding during the hospitalization of second birth parturient is at the upper middle level.Its influencing factors include delivery mode,crater nipple,milk secretion condition and so on.Clinical targeted intervention should be carried out to improve the rate of exclusive breastfeeding.