Dimitraki Marina, Tsikouras Panagiotis, Manav Bachar, Gioka Theodora, Koutlaki Nikoletta, Zervoudis Stefanos, Galazios Georgios
Department of Ob/Gyn, University Hospital of Alexandroupolis, Democritus University of Thrace, 68100, Alexandroupolis, Greece.
Department of Laboratory, University Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece.
Arch Gynecol Obstet. 2016 Feb;293(2):317-28. doi: 10.1007/s00404-015-3783-1. Epub 2015 Jun 26.
The amount of stress experienced by both the mother and fetus during labor and delivery varies considerably and is likely to be different in primiparous and multiparous women as well as in those who receive analgesia during labor and those who do not receive.
In this study, we explored relations between stress during birth experience and lactogenesis of 100 women, who experienced vaginal delivery in Department of Obstetrics and Gynecology of University Hospital of Alexandroupolis.
Stress hormones (cortisol and glucose) were measured in serum (cord and maternal blood) immediately after delivery. Moreover, breast-feeding frequency on day 4, the time when the subjects first felt fullness in the breasts, milk volume on day 4 postpartum and duration of labor were recorded. Also, we recorded maternal exhaustion score during labor and positive and negative affects, posttraumatic stress score and mother-infant bonding rate, with the use of questionnaires.
There were significant intercorrelations among the outcome variables. Mothers who experienced pain, exhaustion and negative feelings in a stressful and long labor had delayed onset of lactation.
These results indicate that primiparity, long labor, stress to the mother and fetus during labor and delivery, negative affects and high score of posttraumatic stress are risk factors for delayed lactogenesis.
分娩过程中母亲和胎儿所经历的压力程度差异很大，初产妇和经产妇以及分娩时接受镇痛和未接受镇痛的产妇之间的压力可能有所不同。
在本研究中，我们探讨了100名在亚历山德鲁波利斯大学医院妇产科经阴道分娩的女性的分娩经历压力与泌乳之间的关系。
分娩后立即测定血清（脐带血和母血）中的应激激素（皮质醇和葡萄糖）。此外，记录第4天的母乳喂养频率、受试者首次感到乳房胀满的时间、产后第4天的乳汁量和产程。我们还使用问卷记录了分娩期间的母亲疲惫评分、正负情绪、创伤后应激评分和母婴依恋率。
各结局变量之间存在显著的相互关联。在压力大且产程长的情况下经历疼痛、疲惫和负面情绪的母亲泌乳开始延迟。
这些结果表明，初产、产程长、分娩过程中母亲和胎儿所承受的压力、负面情绪以及创伤后应激高分是泌乳延迟的危险因素。
