Deng Yuan, Huang Yan, Ning Ping, Ma Se-Ge, He Pei-Yu, Wang Ying
West China School of Nursing, Sichuan University/Department of Nursing, West China Second University Hospital, Sichuan University, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan, China.
Department of Breast, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.
West J Nurs Res. 2021 Jul;43(7):698-708. doi: 10.1177/0193945920967674. Epub 2020 Oct 22.
This meta-analysis was conducted to identify maternal risk factors for lactational mastitis. Studies published in English or Chinese were retrieved from Medline (PubMed), Embase, Cochrane Library, Web of Science, CNKI, WANFANG, and VIP databases according to predefined inclusion and exclusion criteria. Study quality was assessed by the Newcastle-Ottawa Scale. A random-effects model was used for data pooling and I tests to assess study heterogeneity. Pooled data from 8 cohorts and 10 case-control studies identified previous mastitis during breastfeeding (P<0.00001), cesarean section (P=0.001), breast trauma (P<0.001), anemia (P=0.0001), latch problems ≤ 8 weeks post-delivery (P=0.003), milk overproduction (P=0.002), blocked duct (P<0.0001), cracked nipple (especially ≤ 4 weeks post-delivery) (P=0.0001), use of nipple shields (P<0.00001), nipple cream (P<0.0001), brassieres (P<0.0001), and breast pumps (P<0.00001), and breastfeed duration > 30 min (P=0.008) as significant risk factors. Washing nipples before breastfeeding decreased lactational mastitis risk. Identification of these risk factors may facilitate the development of nursing care protocols for reducing lactational mastitis.
本荟萃分析旨在确定哺乳期乳腺炎的母体风险因素。根据预先设定的纳入和排除标准，从Medline（PubMed）、Embase、Cochrane图书馆、Web of Science、中国知网、万方和维普数据库中检索以英文或中文发表的研究。采用纽卡斯尔-渥太华量表评估研究质量。使用随机效应模型进行数据合并和I检验以评估研究异质性。来自8个队列研究和10个病例对照研究的汇总数据确定，既往母乳喂养期间患乳腺炎（P<0.00001）、剖宫产（P=0.001）、乳房外伤（P<0.001）、贫血（P=0.0001）、产后≤8周存在含接问题（P=0.003）、乳汁分泌过多（P=0.002）、乳腺导管堵塞（P<0.0001）、乳头皲裂（尤其是产后≤4周）（P=0.0001）、使用乳头保护罩（P<0.00001）、乳头霜（P<0.0001）、胸罩（P<0.0001）和吸奶器（P<0.00001）以及母乳喂养持续时间>30分钟（P=0.008）为显著风险因素。母乳喂养前清洗乳头可降低哺乳期乳腺炎风险。识别这些风险因素可能有助于制定降低哺乳期乳腺炎的护理方案。
