新生儿早期基本保健对初产妇泌乳启动时间 新生儿体温和体质量变化及并发症发生率的影响

Effect of early essential newborn care on starting time of lactation,change of neonatal body temperature and weight,and incidence rate of complications

目的探讨新生儿早期基本保健(EENC)对初产妇泌乳启动时间、新生儿体温和体质量变化及并发症发生率的影响。方法选取2019年10月—2020年4月于浙江大学医学院附属杭州市第一人民医院自然分娩的104对初产妇及新生儿按照随机数字表法划分成对照组、研究组各52对,其对照组采取常规保健,研究组实施EENC。对两组产妇泌乳启动时间做好记录,采用母乳喂养测量工具(BAT)评估两组首次母乳喂养情况,且统计首次母乳喂养成功率;测量两组新生儿出生时、出生2 h及4 h腋温及出生时、出院时、出院1个月体质量,并对新生儿并发症发生率进行统计。结果研究组泌乳启动时间明显较对照组的短,BAT得分、首次母乳喂养成功率明显较对照组高,差异均有统计学意义(P<0.05)。研究组出生后2 h、4 h体温与出生时相比均明显较高,对照组出生后4 h与出生时相比均明显较高,研究组出生后2 h、4 h体温均明显较对照组高,差异均有统计学意义(P<0.05)。两组出院时体质量与出生时相比均明显较低,出院1个月两组体质量与出生时、出院时相比均明显较高,差异均有统计学意义(P<0.05);研究组出院1个月体质量明显较对照组高,差异有统计学意义(P<0.05)。研究组新生儿肺炎、高胆红素血症发生率明显较对照组低,差异均有统计学意义(P<0.05)。结论EENC可缩短产妇泌乳启动时间,提高产妇首次母乳喂养成功率,同时可增高新生儿体温,促进其体质量增长,并降低新生儿肺炎、高胆红素血症等并发症发生率。

Objective To explore the effect of early essential newborn care(EENC) on starting time of lactation,change of neonatal body temperature and weight,and incidence rate of complications.Methods From October 2019 to April 2020,104 pairs of primiparous women and their neonates born in Affiliated Hangzhou First People’s Hospital,Medical College of Zhejiang University were selected and divided into control group and study group equally according to random number table.The primiparous women and their neonates received routine health care,and the primiparous women and their neonates received EENC.The starting time of lactation in the two groups were recorded,the first breastfeeding situations in the two groups were evaluated by breastfeeding assessment tool(BAT),the successful rates of the first breastfeeding were calculated.The levels of axillary temperature at birth and 2,4 hours after birth in the two groups were measured;neonatal weights at birth,when leaving the hospital,and at one month after leaving the hospital were measured,the incidence rates of neonatal complications were calculated.Results The starting time of lactation in study group was shorter than that in control group,BAT score and successful rate of the first breastfeeding in study group were higher than those in control group(all P<0.05).At 2 hours and 4 hours after birth,body temperatures in study group were higher than that at birth,body temperature at 4 hours after birth in control group was higher than that at birth,body temperatures at 2 hours and 4 hours after birth in study group were higher than those in control group,there were statistically significant differences(P<0.05).Body weights when leaving the hospital in the two group were lower than those at birth,body weights at one month after leaving the hospital were higher than those at birth and when leaving the hospital(P<0.05).Body weight at one month after leaving the hospital in study group was higher than that in control group(P<0.05).The incidence rates of neonatal pneumonia and hyperbilirubinemia in study group were statistically significantly lower than those in control group(P<0.05).Conclusion EENC can shorten the starting time of lactation,improve the successful rate of the first breastfeeding,increase body temperature of neonates,promote the growth of body weight,and reduce the incidence rates of complications,such as neonatal pneumonia and hyperbilirubinemia.