助产士引导下营养及体重管理对初产妇自然分娩及新生儿状况影响

Effects of midwife-guided nutrition and weight management of primiparas on their natural delivery rate and neonatal status

目的:探究助产士引导下营养及体重管理对初产妇自然分娩及新生儿状况的影响。方法:选取2020年1月-2022年6月在本院建档并定期产前检查的98例初产妇,单双球法随机分为对照组和观察组各49例,对照组给予常规管理,观察组给予助产士引导下营养及体重管理。观察两组营养物质摄入情况(总蛋白、总胆固醇、叶酸、钙、镁、锌)、孕前分娩恐惧[汉化孕前分娩恐惧量表(CFPP)]、分娩结局(自然分娩、剖宫产、难产),新生儿Apgar评分及结局(巨大儿、低体重儿、胎儿宫内窘迫、新生儿窒息)。结果:观察组各营养物质摄入量及自然分娩率(83.7%)高于对照组(61.3%),CFPP评分疼痛和失控的恐惧(12.34±3.07分)、并发症的恐惧(6.48±1.21分)、分娩后身体变化的恐惧(4.89±1.14分)低于对照组(14.26±3.22分、7.33±1.85分、5.57±1.25分),难产(8.2%)、巨大儿(0)发生率低于对照组(24.5%、12.2%)(均P<0.05);新生儿Apgar评分(8.37±0.48分、8.23±0.44分)无差异(P>0.05)。结论:助产士引导下营养及体重管理可以有效改善初产妇营养状况,缓解产前分娩恐惧,提高自然分娩率,改善新生儿状况。

Objective:To explore the efects of midwife guided nutritin and weight management of primiparas on their natural delivery rate and nconatal status.Methods:98 primiparas who had been established documents of perinatal pe-riod and had regular prenatal examination in the hospital were selected as the research subjects,and were randomly di-vided into two groups(49 cases in each group)by single double ball method from January 2020 to June 2022.The pri-miparas in the control group were given routine management,while the primiparas in the observation group were given midwife guided nutrition and weight management on the basis of routine management.The intake status of nutrients,such total protein,total cholesterol,folic acid,calcium,magnesium,and zinc,the pre pregnancy delivery fear evalua-ted by Chinese version of Childbirth Fear Prior to Pregnancy Scale(CFPP),the delivery outcomes,such as natural de-livery,cesarean section,and dystocia,of the primiparas,and the neonatal Apgar score,and the nconatal outcomes。such as macrosomia,low birth weight infant,fetal intrauterine distress,and neonatal asphyxia,in the two groups were observed.Results:The nutrient intake situation of the primiparas in the observation group was significantly bet-ter than that of the primiparas in the control group.The rate of the natural delivery(83.7%)of the primiparas in the observation group was signficently higher than that(61.3%)of the primiparas in the control group.The scores of the fear for pain and loss of control(12.34±3.07 points),the fear for complications(6.48±1.21 points),and the fear for physical changes after delivery of(4.89±1.14 points)evaluated by CFPP of the primiparas in the observation group were signficently lower than those(14.26±3.22 points,7.33±1.85 points,and 5.57±1.25 points)of the primiparas in the control group.The incidences of dystocia(8.2%)and macrosomia(0)of the primiparas in the observation group were signficently lower than those(24.5%and 12.2%)of the primiparas in the control group(all P<0.05).There was no signficent difference in the nconatal Apgar score(8.37±0.48 points vs.8.23±0.44 points)of the primiparas between the two groups(P>0.05).Conclusion:Midwife guided nutrition and weight management of the primiparas can improve their nutritional status,alleviate their fear of pre pregnancy delivery,increase their rate of natural deliver-y,and improve their neonatal status.