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分娩期间的产妇镇痛会干扰新生儿行为:对母乳喂养、体温和啼哭的影响。

Maternal analgesia during labor disturbs newborn behavior: effects on breastfeeding, temperature, and crying.

作者信息

Ransjö-Arvidson A B, Matthiesen A S, Lilja G, Nissen E, Widström A M, Uvnäs-Moberg K

机构信息

Division of Reproductive and Perinatal Health Care at the Department of Women and Child Health, Karolinska Institutet, Stockholm, Sweden.

出版信息

Birth. 2001 Mar;28(1):5-12. doi: 10.1046/j.1523-536x.2001.00005.x.

Abstract

BACKGROUND

Newborns not exposed to analgesia, when placed on the mother's chest, exhibit an inborn prefeeding behavior. This study was performed to assess the effects of different types of analgesia during labor on the development of spontaneous breastfeeding movements, crying behavior, and skin temperature during the first hours of life in healthy term newborns.

METHODS

Video recordings were made of 28 newborns who had been dried and placed in skin-to-skin contact between their mother's breasts immediately after delivery. The video recordings were analyzed blindly with respect to infant exposure to analgesia. Defined infant behaviors were assessed every 30 seconds. Group 1 mothers (n = 10) had received no analgesia during labor, group 2 mothers (n = 6) had received mepivacaine via pudendal block, and group 3 mothers (n = 12) had received pethidine or bupivacaine or more than one type of analgesia during labor.

RESULTS

All infants made finger and hand movements, but the infant's massagelike hand movements were less frequent in infants whose mothers had received labor analgesia. A significantly lower proportion of group 3 infants made hand-to-mouth movements (p < 0.001), and a significantly lower proportion of the infants in groups 2 and 3 touched the nipple with their hands before suckling (p < 0.01), made licking movements (p < 0.01), and sucked the breast (p < 0.01). Nearly one-half of the infants, all in groups 2 or 3, did not breastfeed within the first 2.5 hour of life. The infants whose mothers had received analgesia during labor had higher temperatures (p = 0.03) and they cried more (p = 0.05) than infants whose mothers had not received any analgesia.

CONCLUSIONS

The present data indicate that several types of analgesia given to the mother during labor may interfere with the newborn's spontaneous breast-seeking and breastfeeding behaviors and increase the newborn's temperature and crying.

摘要

背景

未接受镇痛的新生儿趴在母亲胸前时,会表现出一种天生的预喂养行为。本研究旨在评估分娩期间不同类型的镇痛对健康足月儿出生后最初几小时内自发母乳喂养动作、啼哭行为和皮肤温度发育的影响。

方法

对28名新生儿进行录像,这些新生儿在出生后立即擦干并置于母亲双乳之间进行皮肤接触。录像在婴儿是否接受镇痛不知情的情况下进行分析。每30秒评估一次特定的婴儿行为。第1组母亲(n = 10)在分娩期间未接受镇痛,第2组母亲(n = 6)通过阴部阻滞接受了甲哌卡因,第3组母亲(n = 12)在分娩期间接受了哌替啶或布比卡因或不止一种类型的镇痛。

结果

所有婴儿都有手指和手部动作,但母亲接受分娩镇痛的婴儿类似按摩的手部动作较少。第3组婴儿进行手到嘴动作的比例显著较低(p < 0.001),第2组和第3组婴儿在吸吮前用手触摸乳头的比例显著较低(p < 0.01),进行舔舐动作的比例显著较低(p < 0.01),吸吮乳房的比例显著较低(p < 0.01)。几乎一半的婴儿,均在第2组或第3组,在出生后2.5小时内未进行母乳喂养。母亲在分娩期间接受镇痛的婴儿体温较高(p = 0.03),且比母亲未接受任何镇痛的婴儿哭得更多(p = 0.05)。

结论

目前的数据表明,母亲在分娩期间接受的几种类型的镇痛可能会干扰新生儿自发的寻乳和母乳喂养行为,并提高新生儿的体温和啼哭频率。

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