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哺乳期使用激素避孕药对婴儿的奶量摄入和生长的影响。

Effect of hormonal contraceptives during breastfeeding on infant's milk ingestion and growth.

机构信息

Department of Obstetrics and Gynecology, Faculty of Medical Sciences, University of Campinas, Campinas, Brazil.

出版信息

Fertil Steril. 2013 Aug;100(2):445-50. doi: 10.1016/j.fertnstert.2013.03.039. Epub 2013 Apr 23.

Abstract

OBJECTIVE

To measure infants' breast milk intake and infant growth when their mothers initiated either combined oral contraceptive (COC), levonorgestrel-releasing intrauterine system, or etonogestrel-releasing implant, or copper intrauterine device (IUD) as a reference group.

DESIGN

Prospective trial.

SETTING

University-based hospital.

PATIENT(S): On postpartum day 42, 40 women initiated a contraceptive method according to their choice.

INTERVENTION(S): Deuterium (D2O; 0.5 g/kg mother's weight) was ingested by mothers on postpartum days 42, 52, and 63 as a marker of total body fluid.

MAIN OUTCOME MEASURE(S): Infants' milk intake from 42 to 63 postpartum days was assessed by measurement of D2O levels in infants' saliva and infant growth by measuring their body weight, height, and tibia length. Women recorded all infant feed and changes of diapers wet with urine. Breastfeeding continuation was assessed at 6 months postpartum.

RESULT(S): Infant mean milk intake, mean growth increase, mean number of breastfeeding episodes, daily wet diaper changes, and mean duration of exclusively breastfeeding (~5 months) were similar in the four groups.

CONCLUSION(S): Use of a COC, the two progestin-only contraceptives, or copper IUD did not affect the amount of infant milk intake and growth up to 9 weeks of age. The incidence of full breastfeeding and breastfeeding continuation was similar with contraceptive hormonal use and no use.

CLINICAL TRIALS REGISTRATION NUMBER

NCT01388582.

摘要

目的

测量婴儿的母乳摄入量和婴儿生长情况,当他们的母亲开始使用复方口服避孕药(COC)、左炔诺孕酮释放宫内节育系统、依托孕烯释放植入物或铜宫内节育器(IUD)时,将其作为参考组。

设计

前瞻性试验。

地点

大学附属医院。

患者

产后第 42 天,40 名妇女根据自己的选择选择了一种避孕方法。

干预

母亲在产后第 42、52 和 63 天摄入氘(D2O;0.5 克/公斤母亲体重)作为总体液标志物。

主要观察指标

通过测量婴儿唾液中的 D2O 水平评估婴儿从产后第 42 天到第 63 天的母乳摄入量,并通过测量婴儿体重、身高和胫骨长度评估婴儿生长情况。妇女记录所有婴儿喂养和尿液浸湿的尿布更换情况。在产后 6 个月评估母乳喂养的持续情况。

结果

四组婴儿的平均母乳摄入量、平均生长增加量、平均母乳喂养次数、每日湿尿布更换次数和纯母乳喂养的平均持续时间(约 5 个月)相似。

结论

使用 COC、两种孕激素避孕药或铜 IUD 不会影响婴儿在 9 周龄前的母乳摄入量和生长。激素避孕的使用和不使用对完全母乳喂养和母乳喂养的持续时间的发生率相似。

临床试验注册号

NCT01388582。

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