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产后48小时早期皮肤接触对母乳量及母乳喂养性黄疸的影响。

Effect of Early Skin-to-Skin Contact to Breast Milk Volume and Breastfeeding Jaundice at 48 Hours after Delivery.

作者信息

Hemachandra Aurasa, Puapornpong Pawin, Ketsuwan Sukwadee, Imchit Chayapa

出版信息

J Med Assoc Thai. 2016 Nov;99 Suppl 8:S63-S69.

Abstract

OBJECTIVE

To evaluate effect of maternal-infant skin-to-skin contact in the first hour postbirth to breast milk volume and breastfeeding jaundice at 48 hours after delivery.

MATERIAL AND METHOD

This was a prospective cohort study. The subjects were 133 postpartum women, who delivered without complications between October 2013 and July 2014 at MSMC and was allocated into early skin-to-skin contact (SSC) and control groups. In the SSC group, the newborns were placed prone on mothers’ bare chest after finishing routine newborn care for at least 30 minutes. The breast milk volume were collected at 16-24 hours, 40-48 hours postpartum and before discharge. The infants’ microbilirubins were measured at 48 hours postbirth. Demographic data including age, parity, GA at delivery, birth weight and gender of the newborns were collected. Data were analyzed using descriptive statistics, Chi-square test and t-test.

RESULTS

The mean breast milk volume in the SSC group were 5.68+5.46, 16.98+11.09, and 31.44+20.06 milliliters at 16-24 hours, 40-48 hours postpartum and before discharge, respectively, while the mean breast milk volume in the control group were 6.19+5.77, 13.99+13.07 and 25.81+20.26 milliliters, respectively in the same period of time, and no statistically difference of the breast milk volume was found between the two groups. The percentage of mothers who had the onset of lactation within 24 hours postpartum in the SSC group (95.51%, 85/89) was significantly higher than the control group (77.27%, 34/44, p<0.01). The percentages of breastfeeding jaundice cases were 16.85 in the SSC group and 27.27 in the control group, and had no significant difference.

CONCLUSION

Early skin-to-skin contact had no direct effect to breast milk volume and incidence of breastfeeding jaundice at 48 hours after delivery but related to the onset of lactation within 24 hours postpartum.

摘要

目的

评估产后第一小时母婴皮肤接触对产后48小时母乳量及母乳喂养性黄疸的影响。

材料与方法

这是一项前瞻性队列研究。研究对象为133名产后妇女,她们于2013年10月至2014年7月在MSMC无并发症分娩,并被分为早期皮肤接触(SSC)组和对照组。在SSC组,新生儿在完成常规新生儿护理后至少30分钟俯卧于母亲裸露的胸部。在产后16 - 24小时、40 - 48小时及出院前收集母乳量。在出生后48小时测量婴儿的微量胆红素。收集包括年龄、产次、分娩时孕周、出生体重及新生儿性别的人口统计学数据。数据采用描述性统计、卡方检验和t检验进行分析。

结果

SSC组在产后16 - 24小时、40 - 48小时及出院前的平均母乳量分别为5.68 + 5.46、16.98 + 11.09和31.44 + 20.06毫升,而对照组在同一时期的平均母乳量分别为6.19 + 5.77、13.99 + 13.07和25.81 + 20.26毫升,两组间母乳量无统计学差异。SSC组产后24小时内泌乳开始的母亲比例(95.51%,85/89)显著高于对照组(77.27%,34/44,p < 0.01)。母乳喂养性黄疸病例的比例在SSC组为16.85%,在对照组为27.27%,无显著差异。

结论

早期皮肤接触对产后48小时的母乳量及母乳喂养性黄疸发生率无直接影响,但与产后24小时内泌乳开始有关。

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