İlhan Gülşah, Atmaca Fatma V, Çümen Ayşenur, Zebitay Ali G, Güngör Emre S, Karasu Ayşe F G
Department of Obstetrics and Gynecology, Süleymaniye Women and Children's Health Training and Research Hospital, Istanbul, Turkey.
Department of Obstetrics and Gynecology, Bezmi alem Vakıf University, Istanbul, Turkey.
J Obstet Gynaecol Res. 2018 Apr;44(4):717-722. doi: 10.1111/jog.13562. Epub 2018 Jan 5.
The circadian timing system has a rhythm and one of the roles of this system is the mediation of hormonal and metabolic adaptations to lactation. This study was conducted to determine whether the time to stage II lactogenesis differed in women who underwent cesarean section (CS) in the daytime (DT) or night-time (NT).
This study was conducted at Süleymaniye Research and Education Hospital between June and December 2016. Two hundred and eighty-eight mothers who had a cesarean delivery and their healthy singleton neonates were included. Clinical and demographic data of the mothers and neonates, time of initiation of breastfeeding and time to stage II lactogenesis were analyzed according to DT or NT CS groups.
There were no statistically significant differences in age, gravida, parity, body mass index, week of gestation at birth, postoperative hemoglobin level, cesarean indications, anesthesia type, previous history of breastfeeding, transfusion need, Apgar scores or birth weight-height of neonates between the DT and NT CS groups. While the time of initiation of breastfeeding did not differ statistically in terms of DT or NT CS groups, the time to stage II lactogenesis was significantly longer in the NT CS group.
NT cesarean delivery is a risk factor for the delayed onset of lactogenesis. The results of this study may be useful to clinical practitioners counseling mothers who undergo NT cesarean delivery.
昼夜节律系统具有节律性，该系统的作用之一是调节激素和代谢以适应泌乳。本研究旨在确定在白天（DT）或夜间（NT）接受剖宫产（CS）的女性进入二期泌乳的时间是否存在差异。
本研究于2016年6月至12月在苏莱曼尼耶研究与教育医院进行。纳入了288例剖宫产的母亲及其健康的单胎新生儿。根据DT或NT CS组分析母亲和新生儿的临床和人口统计学数据、开始母乳喂养的时间以及进入二期泌乳的时间。
DT和NT CS组在年龄、孕次、产次、体重指数、出生孕周、术后血红蛋白水平、剖宫产指征、麻醉类型、既往母乳喂养史、输血需求、阿氏评分或新生儿出生体重-身高方面无统计学显著差异。虽然DT或NT CS组开始母乳喂养的时间在统计学上没有差异，但NT CS组进入二期泌乳的时间明显更长。
NT剖宫产是泌乳延迟开始的一个危险因素。本研究结果可能有助于临床医生为接受NT剖宫产的母亲提供咨询。
