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催产素受体拮抗剂(阿托西班)在早产威胁中的应用:对足月儿母乳喂养有何影响?

Oxytocin Receptor Antagonist (Atosiban) in the Threat of Preterm Birth: Does It Have Any Effect on Breastfeeding in the Term Newborn?

作者信息

López Gómez Lucía, Marín Gabriel Miguel A, Encinas Begoña, de la Cruz Troca Juan J, Rodríguez Marrodán Belén

机构信息

1 Autónoma University , Madrid, Spain .

2 Department of Neonatology, Puerta de Hierro Majadahonda University Hospital , Madrid, Spain .

出版信息

Breastfeed Med. 2018 Mar;13(2):123-128. doi: 10.1089/bfm.2017.0206. Epub 2018 Jan 22.

Abstract

AIM

Oxytocin is a hormone involved in the mechanism of breastfeeding, uterine contractions, and social relationships. Atosiban (competitive oxytocin antagonist) is one of the most commonly used tocolytics for the threat of preterm labor in Europe. The aim of this study is to determinate if the administration of atosiban has any influence in the type of feeding in the term newborn at discharge. The secondary objective is to verify its effectiveness for the prevention of preterm delivery and in the possibility of applying treatment to complete lung maturation.

MATERIALS AND METHODS

Retrospective cohort study carried out in a tertiary University Hospital distinguished by WHO-UNICEF as a Baby-Friendly Hospital Initiative. The analysis included 264 women exposed to atosiban during a period of 4 years. One hundred met inclusion criteria. Unexposed infants born right after and before the exposed ones were selected as the not exposed subgroup (n = 200).

RESULTS

Among women treated with atosiban, 82% maintained exclusively breastfed (EBF), 8% had mixed breastfeeding, and 10% had formula feeding at discharge. In the nonexposed group, 82% maintained EBF, 9.5% had mixed breastfeeding, and 8.5% had formula feeding at discharge (p = 0.84). 97.5% of pregnant women treated with atosiban received corticosteroid for lung maturation, and 49.5% completed gestation with term newborns.

CONCLUSION

There were no significant differences in the type of feeding at discharge between the atosiban group and the nonexposed group. In most cases, the administration of tocolytic therapy allowed to complete lung maturation.

摘要

目的

催产素是一种参与母乳喂养、子宫收缩和社会关系机制的激素。阿托西班(竞争性催产素拮抗剂)是欧洲用于治疗早产威胁最常用的宫缩抑制剂之一。本研究的目的是确定阿托西班的使用对足月新生儿出院时的喂养方式是否有任何影响。次要目的是验证其预防早产的有效性以及应用该治疗促进肺成熟的可能性。

材料与方法

在一所被世界卫生组织 - 联合国儿童基金会指定为“爱婴医院倡议”的三级大学医院进行回顾性队列研究。分析纳入了4年间264名接受阿托西班治疗的女性。其中100名符合纳入标准。选取在接受阿托西班治疗的婴儿前后出生的未暴露婴儿作为未暴露亚组(n = 200)。

结果

在接受阿托西班治疗的女性中,82%在出院时维持纯母乳喂养(EBF),8%为混合喂养,10%为配方奶喂养。在未暴露组中,82%在出院时维持纯母乳喂养,9.5%为混合喂养,8.5%为配方奶喂养(p = 0.84)。97.5%接受阿托西班治疗的孕妇接受了糖皮质激素以促进肺成熟,49.5%足月分娩。

结论

阿托西班组和未暴露组在出院时的喂养方式上无显著差异。在大多数情况下,宫缩抑制治疗可促进肺成熟。

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