School of Nursing, Fujian University of Traditional Chinese Medicine, Fuzhou, China.
Department of Nursing, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, China.
Breastfeed Med. 2021 May;16(5):385-392. doi: 10.1089/bfm.2020.0356. Epub 2021 Apr 23.
Gestational diabetes mellitus (GDM) may be associated with delayed onset of lactogenesis (DOL), but it is still inconclusive. The study aimed to evaluate the association between GDM and DOL, the prevalence and risk factors of DOL in GDM women. A comprehensive search was performed in 10 electronic databases from inception to June 1, 2020. To find more eligible studies, the references of finally eligible studies and relevant reviews were traced manually. A meta-analysis was conducted to calculate the pooled estimates of association, prevalence, and risk factors using random- or fixed-effects models. Eleven eligible articles involving 8,150 women were included in this study. GDM women had a higher risk of DOL (odds ratio [OR] = 1.84, 95% confidence interval [CI] [1.34-2.52]). The prevalence of delayed lactogenesis onset in GDM women was 35.0% (effect size [ES] = 0.35, 95% CI [0.30-0.40]). Primipara (OR = 2.54, 95% CI [1.89-3.42]), advanced age (OR = 1.05, 95% CI [1.03-1.08]), prepregnancy obesity (OR = 1.55, 95% CI [1.19-2.03]), and insulin treatment (OR = 3.07, 95% CI [1.71-5.47]) were risk factors of delayed lactogenesis onset in GDM women. GDM negatively affects the timing of lactogenesis onset. The prevalence of delayed lactogenesis onset in GDM women is 35.0%. Primipara, advanced age, prepregnancy obesity, and insulin treatment are independent risk factors of delayed lactogenesis onset in GDM women.
妊娠期糖尿病（GDM）可能与泌乳启动延迟（DOL）有关，但结论仍不确定。本研究旨在评估 GDM 与 DOL 的关系，以及 GDM 妇女 DOL 的发生率和危险因素。从建库至 2020 年 6 月 1 日，我们对 10 个电子数据库进行了全面检索。为了找到更多合格的研究，还手动追踪了最终合格研究的参考文献和相关综述。采用随机或固定效应模型进行荟萃分析，计算关联、发生率和危险因素的汇总估计值。本研究纳入了 11 项涉及 8150 名妇女的合格文章。GDM 妇女发生 DOL 的风险更高（比值比 [OR] = 1.84，95%置信区间 [CI] [1.34-2.52]）。GDM 妇女泌乳启动延迟的发生率为 35.0%（效应量 [ES] = 0.35，95% CI [0.30-0.40]）。初产妇（OR = 2.54，95% CI [1.89-3.42]）、高龄（OR = 1.05，95% CI [1.03-1.08]）、孕前肥胖（OR = 1.55，95% CI [1.19-2.03]）和胰岛素治疗（OR = 3.07，95% CI [1.71-5.47]）是 GDM 妇女泌乳启动延迟的危险因素。GDM 会对泌乳启动的时间产生负面影响。GDM 妇女泌乳启动延迟的发生率为 35.0%。初产妇、高龄、孕前肥胖和胰岛素治疗是 GDM 妇女泌乳启动延迟的独立危险因素。
