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哺乳期使用左炔诺孕酮紧急避孕药;对婴儿健康与发育的影响。

Levonorgestrel emergency contraceptive pills use during breastfeeding; effect on infants' health and development.

作者信息

Shaaban Omar M, Abbas Ahmed M, Mahmoud Hanaa R, Yones Entsar M, Mahmoud Ahmed, Zakherah Mahmoud S

机构信息

a Department of Obstetrics and Gynecology , Faculty of Medicine, Assiut University , Assiut , Egypt.

b Department of Obstetric and Gynecological Nursing , Faculty of Nursing, Assiut University , Assiut , Egypt.

出版信息

J Matern Fetal Neonatal Med. 2019 Aug;32(15):2524-2528. doi: 10.1080/14767058.2018.1439470. Epub 2018 Feb 20.

Abstract

OBJECTIVE

The current study aims to evaluate the effect of the use of single packet of levonorgestrel emergency contraceptive pills (LNG-ECPs) during breastfeeding on the health and development of the nursing infant.

MATERIALS AND METHODS

The current study was an ancillary observational cohort study carried out in a university hospital. We counseled all women delivered and planning birth-space and breastfeed for at least 1 year for participation during postpartum hospital stay. Eligible participants for inclusion in the randomized controlled trial (NCT01111929) were allocated to receive adequate Lactational Amenorrhea Method (LAM) counseling (LAM-only group) or the LAM counseling in addition to counseling about LNG-ECPs use (LAM + emergency contraception (EC) group). These pills were to be used once if unprotected intercourse did occur after expiry of any of the LAM prerequisites and before the couples started to use a reliable method of contraception. We included the first 100 women in the LAM + EC who did use the pills and the first 100 women in the control group who completed the follow-up visits for 6 months to draw the infants' outcome. The primary outcome was the difference of anthropometric measurements of the infants at 3 and 6 months postpartum. Secondary outcome was the difference in the Psycho-social, fine and gross motor, and language development using Denver development screening test.

RESULTS

There were no statistical significant differences between both the groups regarding the infants' weight, length, head circumference, chest circumference, and mid-arm circumference at each visit (p > .05). Additionally, there were no statistically significant differences regarding all items (psycho-social, fine and gross motor, and language) of Denver development screening test between the infants in LAM-only and LAM + EC groups (p = .081).

CONCLUSIONS

The use of single packet of LNG-ECPs during breastfeeding not objectively affects health and development of nursing infants or subjectively affects the quantity of breast milk.

摘要

目的

本研究旨在评估哺乳期使用单剂左炔诺孕酮紧急避孕药(LNG - ECPs)对哺乳婴儿健康和发育的影响。

材料与方法

本研究是在一家大学医院进行的辅助观察性队列研究。我们在产后住院期间向所有分娩并计划生育间隔且母乳喂养至少1年的女性提供咨询,邀请她们参与研究。符合纳入随机对照试验(NCT01111929)条件的参与者被分配接受充分的哺乳期闭经法(LAM)咨询(仅LAM组)或除LAM咨询外还接受LNG - ECPs使用咨询(LAM + 紧急避孕(EC)组)。如果在任何LAM前提条件期满后且夫妻开始使用可靠避孕方法之前发生了无保护性交,这些药丸将仅使用一次。我们纳入了LAM + EC组中确实使用了药丸的前100名女性以及对照组中完成了6个月随访的前100名女性,以得出婴儿的结局。主要结局是产后3个月和6个月时婴儿人体测量指标的差异。次要结局是使用丹佛发育筛查测试评估的心理社会、精细和粗大运动以及语言发育的差异。

结果

两组在每次访视时婴儿的体重、身长、头围、胸围和上臂围方面均无统计学显著差异(p > 0.05)。此外,仅LAM组和LAM + EC组婴儿在丹佛发育筛查测试的所有项目(心理社会、精细和粗大运动以及语言)方面也无统计学显著差异(p = 0.081)。

结论

哺乳期使用单剂LNG - ECPs不会客观影响哺乳婴儿的健康和发育,也不会主观影响母乳量。

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