Brimdyr Kajsa, Cadwell Karin, Widström Ann-Marie, Svensson Kristin, Neumann Monica, Hart Elaine A, Harrington Sarah, Phillips Raylene
Healthy Children Project, Inc., East Sandwich, MA, USA.
Maternal Child Health, Union Institute and University, Cincinnati, OH, USA.
Birth. 2015 Dec;42(4):319-28. doi: 10.1111/birt.12186. Epub 2015 Oct 13.
Intrapartum drugs, including fentanyl administered via epidural and synthetic oxytocin, have been previously studied in relation to neonatal outcomes, especially breastfeeding, with conflicting results. We examined the normal neonatal behavior of suckling within the first hour after a vaginal birth while in skin-to-skin contact with mother in relation to these commonly used drugs. Suckling in the first hour after birth has been shown in other studies to increase desirable breastfeeding outcomes.
Prospective comparative design. Sixty-three low-risk mothers self-selected to labor with intrapartum analgesia/anesthesia or not. Video recordings of infants during the first hour after birth while being held skin-to-skin with their mother were coded and analyzed to ascertain whether or not they achieved Stage 8 (suckling) of Widström's 9 Stages of newborn behavior during the first hour after birth.
A strong inverse correlation was found between the amount and duration of exposure to epidural fentanyl and the amount of synthetic oxytocin against the likelihood of achieving suckling during the first hour after a vaginal birth.
Results suggest that intrapartum exposure to the drugs fentanyl and synthetic oxytocin significantly decreased the likelihood of the baby suckling while skin-to-skin with its mother during the first hour after birth.
先前已对包括经硬膜外给予的芬太尼和合成缩宫素在内的产时用药与新生儿结局，尤其是母乳喂养之间的关系进行了研究，但结果相互矛盾。我们研究了经阴道分娩后第一小时内，婴儿与母亲皮肤接触时正常的吸吮行为与这些常用药物之间的关系。其他研究表明，出生后第一小时内的吸吮可提高理想的母乳喂养结局。
前瞻性比较设计。63名低风险母亲自行选择是否在产时使用镇痛/麻醉。对婴儿出生后第一小时与母亲皮肤接触时的视频记录进行编码和分析，以确定他们在出生后第一小时内是否达到了维德斯特伦新生儿行为9个阶段中的第8阶段（吸吮）。
发现硬膜外芬太尼的暴露量和持续时间以及合成缩宫素的使用量与经阴道分娩后第一小时内实现吸吮的可能性之间存在强烈的负相关。
结果表明，产时接触芬太尼和合成缩宫素显著降低了婴儿在出生后第一小时与母亲皮肤接触时吸吮的可能性。
