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延迟新生儿沐浴对母乳喂养、低体温和低血糖的影响。

Effects of Delayed Newborn Bathing on Breastfeeding, Hypothermia, and Hypoglycemia.

出版信息

J Obstet Gynecol Neonatal Nurs. 2020 Mar;49(2):181-189. doi: 10.1016/j.jogn.2019.12.004. Epub 2020 Feb 12.

DOI:10.1016/j.jogn.2019.12.004
PMID:32057686
Abstract

OBJECTIVE

To determine whether delaying the newborn bath by 24 hours increases the prevalence of breastfeeding initiation and exclusive breastfeeding at discharge in healthy full-term and late preterm newborns (34 0/7-36 6/7 weeks gestation) and to examine the effect of delayed newborn bathing on the incidences of hypothermia and hypoglycemia.

DESIGN

Pre-post implementation, retrospective, cohort study.

SETTING

Provincial children's hospital with an average of 2,500 births per year.

PARTICIPANTS

Healthy newborns (N = 1,225) born at 34 0/7 weeks or more gestation who were admitted to the mother-baby unit.

METHODS

We compared newborns who were bathed before 24 hours (n = 680, preimplementation group) to newborns who were bathed after 24 hours (n = 545, postimplementation group).

RESULTS

After adjustment for confounders, the odds of exclusive breastfeeding at discharge were 33% greater in the postimplementation group than in the preimplementation group (adjusted odds ratio = 1.334; 95% confidence interval [1.049,1.698]; p = .019). Delayed bathing was associated with decreased incidence of hypothermia and hypoglycemia (p = .007 and p = .003, respectively). We observed no difference in breastfeeding initiation between groups.

CONCLUSION

Delaying the newborn bath for 24 hours was associated with an increased likelihood of exclusive breastfeeding at discharge and a decreased incidence of hypothermia and hypoglycemia in healthy newborns. The implementation of a delayed bathing policy has the potential to improve breastfeeding rates and reduce the incidence of hypothermia and hypoglycemia.

摘要

目的

确定对健康足月和晚期早产儿(34 0/7-36 6/7 周)延迟 24 小时沐浴是否会增加母乳喂养初始率和出院时纯母乳喂养率,并检查延迟新生儿沐浴对体温过低和低血糖发生率的影响。

设计

实施前后、回顾性、队列研究。

地点

每年平均有 2500 名新生儿出生的省级儿童医院。

参与者

胎龄 34 0/7 周或以上且入住母婴病房的健康新生儿(N=1225)。

方法

我们比较了 24 小时内沐浴的新生儿(n=680,实施前组)和 24 小时后沐浴的新生儿(n=545,实施后组)。

结果

调整混杂因素后,实施后组出院时纯母乳喂养的几率比实施前组高 33%(调整后的优势比=1.334;95%置信区间[1.049,1.698];p=0.019)。延迟沐浴与体温过低和低血糖发生率降低相关(p=0.007 和 p=0.003)。两组之间的母乳喂养初始率无差异。

结论

对新生儿延迟 24 小时沐浴与出院时纯母乳喂养率增加和体温过低及低血糖发生率降低相关。延迟沐浴政策的实施有可能提高母乳喂养率并降低体温过低和低血糖的发生率。

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