基于倾向性评分匹配法探究产后疲劳对纯母乳喂养的影响

Effect of postpartum fatigue on exclusive breastfeeding based on propensity score matching

目的探索产后疲劳对纯母乳喂养的影响,以便提高纯母乳喂养率。方法采取便利抽样法,选择2021年4至2022年4月北京市某三级甲等综合医院自然分娩产妇629例,采用一般资料问卷,多维度疲劳量表(multidimensional fatigue inventory,MFI-20)收集相关资料;运用倾向性评分匹配法(propensity score matching,PSM)控制混杂因素,探究产后疲劳对纯母乳喂养的影响。结果共纳入602例产妇,平均年龄(32.5±4.0)岁,产后疲劳平均得分为(46.6±18.5)分,产后疲劳患病率为59.3%,纯母乳喂养率为37.2%;采用倾向性匹配评分法对602例产妇的协变量进行1∶1匹配,匹配后共有202对完成配对,分别为产后疲劳组与非产后疲劳组,其中疲劳组纯母乳喂养率为35.2%,非产后疲劳组纯母乳喂养率为47.5%,两组纯母乳喂养率比较,差异有统计学意义(χ^(2)=6.380,P<0.05);在控制产妇年龄、文化程度、经济状况、妊娠合并症、初/经产妇、产后出血量、婴儿出生体重、会阴伤口类型、总产程时间9个人口学变量后,对匹配后数据进行纯母乳喂养率二元logistic回归分析,结果显示,产后疲劳组放弃纯母乳喂养的风险是非产后疲劳组的3.263倍(OR=3.263,95%CI:2.076~5.130,P<0.001)。结论产后疲劳患病率较高,产后疲劳是产妇放弃纯母乳喂养的主要危险因素,应采取措施降低产后疲劳水平,从而提高纯母乳喂养率。

Objective To study the effect of postpartum fatigue on exclusive breastfeeding based on propensity score matching for the purpose of improving breastfeeding rate.Methods The convenience sampling method was used to select 629 natural birthing puerperal women parturients from a tertiary hospital in Beijing during between April 2021 to and April 2022.The relevant data were collected by using a general information questionnaire and the multidimensional fatigue inventory(MFI-20).The effect of postpartum fatigue on exclusive breastfeeding was investigated,having those and had the mixed blended factors controlled using by the propensity score matching(PSM).Results Totally,A total of 602 puerperal women parturients were included in the study,with an average age of(32.5±4.0)years.It was found that the average score of postpartum fatigue was(46.6±18.5),and the prevalence of postpartum fatigue was 59.3%,and the exclusive breastfeeding rate was 37.2%.Using With PSM,a 1:1 matching was performed based on the covariates of 602 puerperal women parturients.As a result,a total of 202 pairs were respectively matched into two groups:postpartum fatigue and non-postpartum non-fatigue.The exclusive breastfeeding rate was,respectively,35.2%and 47.5%in the postpartum fatigue and non-postpartum fatigue groups,with significant difference between the groups(χ^(2)=6.380,P<0.05).After with 9 controlled for 9 demographic variants:in age,education,financial status,pregnancy comorbidities,primiparity/multiparity,amount of postpartum bleeding volume,infant birth weight of neonate,type of perineal wound and,total duration of labour,binary logistic regression analysis on the postmatching exclusive breastfeeding rate showed the risk of giving up exclusive breastfeeding in the postpartum fatigue group was 3.263 times higher than that in the non-postpartum fatigue group(OR=3.263,95%CI:2.076-5.130,P<0.001).Conclusions The prevalence of postpartum fatigue is higher,and it is the major risk factor for puerperal women parturients to give up the exclusive breastfeeding.It is imperative necessary to take measures to alleviate their a postpartum fatigue in order to the purpose of elevating the rate of exclusive breastfeeding.