Zanardo Vincenzo, Savona Valentina, Cavallin Francesco, D'Antona Donato, Giustardi Arturo, Trevisanuto Daniele
Department of Pediatrics, Padua University School of Medicine, Padua, Italy.
J Matern Fetal Neonatal Med. 2012 Sep;25(9):1595-8. doi: 10.3109/14767058.2011.648238. Epub 2012 Feb 6.
Lactation performance depends on stress surrounding labor and delivery, and it is likely to be different in women who underwent elective cesarean delivery (ECD) or vaginal (VD). The aim of this study was to assess the relationship between cortisol and human prolactin (hPRL), following ECD and lactation performance, from the delivery room to the 6th month of life.
A total of 106 mothers were consecutively enrolled: 38 after ECD, 28 after emergency cesarean delivery (EmCD), and 40 after VD.
Basal stress-, lactogenic-hormones, cortisol, and hPRL were comparable on day 3 postpartum in all the women. Multivariate analysis indicated that ECD has a negative impact (OR; 95% CI) on breastfeeding prevalence on the seventh day (0.14; 0.0-0.44, p=0.008) and at third month post partum (0.19; 0.05-0.71, p=0.05) in comparison to VD. In addition, hPRL levels proved to have a statistically significant role in early breastfeeding (1.01; 1-1.01, p=0.002).
ECD is a risk factor for successful lactation performance. This information should be provided to mothers and caregivers for extra breastfeeding guidance.
泌乳表现取决于分娩时的应激情况，择期剖宫产（ECD）或经阴道分娩（VD）的女性泌乳表现可能有所不同。本研究旨在评估从产房到出生后6个月期间，ECD后皮质醇与人类催乳素（hPRL）之间的关系以及泌乳表现。
连续纳入106名母亲：38名接受ECD，28名接受急诊剖宫产（EmCD），40名经VD分娩。
所有女性产后第3天的基础应激激素、促乳激素、皮质醇和hPRL水平相当。多变量分析表明，与VD相比，ECD对产后第7天（比值比[OR]；95%置信区间[CI]：0.14；0.0 - 0.44，p = 0.008）和产后第3个月（0.19；0.05 - 0.71，p = 0.05）的母乳喂养率有负面影响。此外，hPRL水平在早期母乳喂养中具有统计学意义（1.01；1 - 1.01，p = 0.002）。
ECD是成功泌乳的一个风险因素。应将此信息告知母亲和护理人员，以便提供额外的母乳喂养指导。
