Wang Bing-shun, Zhou Li-feng, Zhu Li-ping, Gao Xiao-ling, Gao Er-sheng
Department of Biostatistics, School of Medicine, Shanghai Jiao Tong University, Shanghai 200025, China.
Zhonghua Fu Chan Ke Za Zhi. 2006 Apr;41(4):246-8.
To study the effects of caesarean section on breastfeeding.
Six hundred and two [301 cases was caesarean section (caesarean section group) and 301 cases was vaginal delivery (vaginal delivery group)] nulliparas were interviewed face-to-face at antepartum and postpartum in an indication-matched prospective study.
There was a significantly lower postpartum prolactin (PRL) level in the caesarean section group (8.48 nmol/L, 95% CI: 7.80 - 9.21 nmol/L) compared with vaginal delivery group (9.61 nmol/L, 95% CI: 8.99 - 10.26 nmol/L) during 6 - 24 hours in the daytime after delivery. The median time of breastfeeding initiation was 12 hours and 2 hours after birth for caesarean section and vaginal delivery groups respectively. Caesarean section was an important hazard for a shorter duration of breastfeeding (RR = 1.21; 95% CI: 1.10 - 1.33) within one year after childbirth.
Caesarean section is associated with significantly lower postpartum PRL, which is in line with the longer breastfeeding initiation and lower rate of successful breastfeeding. Necessary measures including promoting the secretion of postpartum PRL such as early contact, early sucking and analgesic method should be taken to improve the successful breastfeeding rate.
研究剖宫产对母乳喂养的影响。
在一项指征匹配的前瞻性研究中，对602例初产妇[301例行剖宫产（剖宫产组），301例行阴道分娩（阴道分娩组）]在产前和产后进行面对面访谈。
产后白天6至24小时期间，剖宫产组产后催乳素（PRL）水平（8.48 nmol/L，95%可信区间：7.80 - 9.21 nmol/L）显著低于阴道分娩组（9.61 nmol/L，95%可信区间：8.99 - 10.26 nmol/L）。剖宫产组和阴道分娩组开始母乳喂养的中位时间分别为出生后12小时和2小时。剖宫产是产后一年内母乳喂养时间较短的一个重要危险因素（相对危险度=1.21；95%可信区间：1.10 - 1.33）。
剖宫产与产后PRL显著降低有关，这与开始母乳喂养时间较长和母乳喂养成功率较低一致。应采取包括早期接触、早期吸吮和镇痛方法等促进产后PRL分泌的必要措施，以提高母乳喂养成功率。
