Chang Zorina Marzan, Heaman Maureen I
Labor, Delivery, Recovery, Postpartum Unit, Women's Hospital, Health Sciences Centre, Winnipeg, Manitoba, Canada.
J Hum Lact. 2005 Aug;21(3):305-14; quiz 315-9, 326. doi: 10.1177/0890334405277604.
This prospective cohort study examined the association between epidural analgesia during labor and delivery, infant neurobehavioral status, and the initiation and continuation of effective breastfeeding. Healthy, term infants delivered vaginally by mothers who received epidural analgesia (n = 52) or no analgesia (n = 63) during labor and delivery were assessed at 8 to 12 hours postpartum, followed by a telephone interview with the mothers at 4 weeks postpartum. There was no significant difference between the epidural analgesia and no-analgesia groups in breastfeeding effectiveness or infant neurobehavioral status at 8 to 12 hours or in the proportion of mothers continuing to breastfeed at 4 weeks. Therefore, epidural analgesia did not appear to inhibit effective breastfeeding. There was a positive correlation between infant neurobehavioral status and breastfeeding effectiveness (Spearman rho = 0.48, P = .01), suggesting that neurobehavioral assessment may prove beneficial in identifying infants at greater risk for breastfeeding difficulties.
这项前瞻性队列研究探讨了分娩期间硬膜外镇痛与婴儿神经行为状态以及有效母乳喂养的开始和持续之间的关联。对在分娩期间接受硬膜外镇痛（n = 52）或未接受镇痛（n = 63）的母亲经阴道分娩的健康足月儿在产后8至12小时进行评估，随后在产后4周对母亲进行电话访谈。硬膜外镇痛组和未镇痛组在产后8至12小时的母乳喂养效果或婴儿神经行为状态，以及产后4周继续母乳喂养的母亲比例方面均无显著差异。因此，硬膜外镇痛似乎并未抑制有效母乳喂养。婴儿神经行为状态与母乳喂养效果之间存在正相关（斯皮尔曼等级相关系数rho = 0.48，P = .01），这表明神经行为评估可能有助于识别母乳喂养困难风险较高的婴儿。
