产后哺乳期妇女辅食添加与月经恢复及排卵的关系。

Relation of supplementary feeding to resumptions of menstruation and ovulation in lactating postpartum women.

作者信息

Li Wei, Qiu Yi

机构信息

Department of Health Statistics, Fourth Military Medical University, Xi'an 710032, China.

出版信息

Chin Med J (Engl). 2007 May 20;120(10):868-70.

PMID:17543175

Abstract

BACKGROUND

Resumption of menstrual cycles is one of the indicators for restoration of reproductive capability in postpartum women. However, menstruation does not necessarily mean that ovulation has taken place. The aim of this study was to investigate the relation of supplementary feeding to return of menstruation and ovulation after delivery.

METHODS

A questionnaire was used to obtain data from 101 breastfeeding mothers. The following elements were analyzed: age, education level, breastfeeding practice, time of return of menstruation, contraceptive practice, and starting time of supplementary feeding during the lactation at intervals of 6 weeks to 18 months after delivery. The ovulation was continuously monitored by ultrasonography and basal body temperature (BBT) measurement.

RESULTS

By ultrasonography, 53 of the 101 women (52.5%) had the first ovulation (follicle > 1.8 cm in diameter) within 154 days after delivery on average, among whom 11 (10.9%, 11/101) had restoration of ovulation within 4 months and 42 (41.6%, 42/101) had it after 4 months. In women with follicles > 1.8 cm in diameter (n = 53), the menstruation resumed (138 +/- 84) days after delivery, and the supplementary feeding was started at (4.0 +/- 1.1) months, which were significantly earlier than those in the women with follicular diameter < 1.7 cm (n = 48; (293 +/- 88) days, (5.1 +/- 1.3) months; t = 9.003, P < 0.01 and t = 4.566, P < 0.01). In the women with follicles < 1.8 cm in diameter, 30 had return of menstruation before the end of ultrasonographic monitoring, while only 8 in the women with follicular diameter < 1.7 cm had menstrual resumption at the same time (chi(2) = 16.91, P < 0.01). The starting time of supplementary feeding was positively correlated with the time of the restoration of menstruation (n = 100, r = 0.4764, P < 0.01) and first ovulation after delivery (n = 53, r = 0.5554, P < 0.01). In this series, no woman had pregnancy within 18 months postpartum.

CONCLUSION

Supplementary feeding can affect the restoration of menstrual cycles and ovulation in lactating postpartum women.

摘要

背景

月经周期恢复是产后女性生殖能力恢复的指标之一。然而，月经恢复并不一定意味着排卵已经发生。本研究的目的是调查产后辅食添加与月经和排卵恢复之间的关系。

方法

采用问卷调查从101名母乳喂养的母亲中获取数据。分析以下因素：年龄、教育水平、母乳喂养情况、月经恢复时间、避孕措施以及产后6周至18个月哺乳期间辅食添加的开始时间。通过超声检查和基础体温（BBT）测量持续监测排卵情况。

结果

通过超声检查，101名女性中有53名（52.5%）平均在产后154天内首次排卵（卵泡直径>1.8 cm），其中11名（10.9%，11/101）在4个月内恢复排卵，42名（41.6%，42/101）在4个月后恢复排卵。卵泡直径>1.8 cm的女性（n = 53）产后月经恢复时间为（138±84）天，辅食添加开始时间为（4.0±1.1）个月，均显著早于卵泡直径<1.7 cm的女性（n = 48；（293±88）天，（5.1±1.3）个月；t = 9.003，P < 0.01；t = 4.566，P < 0.01）。卵泡直径<1.8 cm的女性中，30名在超声监测结束前恢复月经，而卵泡直径<1.7 cm的女性中只有8名同时恢复月经（χ² = 16.91，P < 0.01）。辅食添加开始时间与月经恢复时间（n = 100，r = 0.4764，P < 0.01）和产后首次排卵时间（n = 53，r = 0.5554，P < 0.01）呈正相关。在本研究系列中，没有女性在产后18个月内怀孕。