McGovern Pat, Dowd Bryan, Gjerdingen Dwenda, Gross Cynthia R, Kenney Sally, Ukestad Laurie, McCaffrey David, Lundberg Ulf
School of Public Health, University of Minnesota, Minneapolis, Minn, USA.
Ann Fam Med. 2006 Mar-Apr;4(2):159-67. doi: 10.1370/afm.519.
Most new mothers return to work soon after childbirth. A need exists to reexamine the definition of postpartum health and evaluate employed women's recovery from childbirth in association with such factors as delivery type and breastfeeding.
Using a prospective cohort design, we recruited Minnesota women into the study while they were hospitalized for childbirth in 2001. Telephone interviews were conducted 5 weeks postpartum. Eligible women were 18 years or older, employed, and spoke English. Multivariate models using 2-stage least squares were used to estimate factors associated with physical and mental health and postpartum symptoms.
A total of 817 women were enrolled (71% response) in the study; 716 women completed interviews at 5 weeks postpartum. On average, women reported 6 postpartum symptoms, most frequently fatigue (64%), breast discomfort (60%), and decreased desire for sex (52%). Findings showed that cesarean (vs vaginal) deliveries were associated with significantly worse physical function, role limitations, and vitality. Multivariate findings showed that the effect of delivery type on physical health was moderately large (beta = -5.96; P = or <.01), and breastfeeding was associated with an increased frequency of postpartum symptoms (beta = 4.63; P = .01).
These mothers experienced several childbirth-related symptoms at 5 weeks postpartum, indicating a need for ongoing rest and recovery. Health concerns were greater for women who were breastfeeding and for those whose babies were delivered by cesarean section, suggesting a need for greater support for these women and a reassessment by the medical community of the progressively growing practice of cesarean deliveries.
大多数新妈妈在分娩后不久便重返工作岗位。因此，有必要重新审视产后健康的定义，并结合分娩方式和母乳喂养等因素，评估职业女性产后的恢复情况。
采用前瞻性队列设计，我们于2001年在明尼苏达州招募了住院分娩的女性参与研究。产后5周进行电话访谈。符合条件的女性年龄在18岁及以上，有工作且会说英语。使用两阶段最小二乘法的多变量模型来估计与身心健康及产后症状相关的因素。
共有817名女性纳入研究（应答率71%）；716名女性在产后5周完成访谈。女性平均报告有6种产后症状，最常见的是疲劳（64%）、乳房不适（60%）和性欲下降（52%）。研究结果显示，剖宫产（与阴道分娩相比）与身体功能明显较差、角色受限和活力下降有关。多变量研究结果表明，分娩方式对身体健康的影响中等偏大（β = -5.96；P≤0.01），母乳喂养与产后症状频率增加有关（β = 4.63；P = 0.01）。
这些母亲在产后5周出现多种与分娩相关的症状，表明需要持续的休息和恢复。母乳喂养的女性以及剖宫产分娩的女性健康问题更多，这表明需要给予这些女性更多支持，同时医疗界需要重新评估剖宫产分娩这种日益增多的做法。
