孕前糖尿病女性的产前母乳喂养咨询干预——一项随机对照试验
Prenatal Breastfeeding Counseling Intervention in Women with Pre-Gestational Diabetes Mellitus-A Randomized Controlled Trial.
作者信息
Schiller Tal, Gassner Tali, Winter Shafran Yael, Knobler Hilla, Schiller Ofer, Kirzhner Alena
机构信息
Department of Diabetes, Endocrinology and Metabolism, Kaplan Medical Center, Rehovot 7661041, Israel.
Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9160401, Israel.
出版信息
Healthcare (Basel). 2024 Feb 4;12(3):406. doi: 10.3390/healthcare12030406.
BACKGROUND
Data on breastfeeding rates and targeted interventions in women with pre-gestational diabetes mellitus are inconclusive. The aim of the study was to evaluate breastfeeding rates up to one year postpartum and whether targeted counseling towards the end of pregnancy can impact breastfeeding rates and duration. An additional goal was to evaluate whether counseling affected women's perceptions regarding breastfeeding.
METHODS
Women with pre-gestational diabetes mellitus were cluster-randomized between 32 and 36 weeks of gestation, either to face-to-face instruction with a certified lactation consultant or to receive written information on breastfeeding. Thirty-eight women without diabetes served as controls and were given written information on breastfeeding. All women filled out a questionnaire regarding intended breastfeeding duration, exclusivity, and perceptions, before intervention and at three, six, and twelve months post-partum.
RESULTS
Fifty-two women with pre-gestational diabetes mellitus consented to participate. All completed the questionnaires, 26 in each group. At three, six, and twelve months postpartum, rates of any breastfeeding were around 60%, 50%, and 30%, respectively. Approximately one-third breastfed exclusively in each group at three and six months. No significant difference in breastfeeding rates was noted between face-to-face instruction, written information, and controls. End-of-pregnancy counseling improved confidence in breastfeeding knowledge and confidence in being able to manage blood glucose.
CONCLUSIONS
Breastfeeding rates in pre-gestational diabetes mellitus were comparable to those of women without diabetes and were unchanged by mode of instruction at the end of pregnancy. However, targeted diabetes-oriented breastfeeding instruction at the end of pregnancy improved knowledge and confidence among women with pre-gestational diabetes mellitus.
背景
关于孕前糖尿病女性的母乳喂养率及针对性干预措施的数据尚无定论。本研究的目的是评估产后一年的母乳喂养率，以及孕期结束时的针对性咨询是否会影响母乳喂养率及持续时间。另一个目标是评估咨询是否会影响女性对母乳喂养的认知。
方法
将孕前糖尿病女性在妊娠32至36周时进行整群随机分组，一组接受认证泌乳顾问的面对面指导，另一组接受关于母乳喂养的书面信息。38名非糖尿病女性作为对照组，接受关于母乳喂养的书面信息。所有女性在干预前以及产后3个月、6个月和12个月填写一份关于预期母乳喂养持续时间、纯母乳喂养情况及认知的问卷。
结果
52名孕前糖尿病女性同意参与。所有人都完成了问卷，每组各26人。在产后3个月、6个月和12个月时，任何形式的母乳喂养率分别约为60%、50%和30%。在3个月和6个月时，每组中约三分之一的女性进行纯母乳喂养。面对面指导组、书面信息组和对照组之间的母乳喂养率无显著差异。孕期结束时的咨询提高了对母乳喂养知识的信心以及对血糖管理能力的信心。
结论
孕前糖尿病女性的母乳喂养率与非糖尿病女性相当且不受孕期结束时指导方式的影响。然而，孕期结束时针对糖尿病的母乳喂养指导提高了孕前糖尿病女性的知识水平和信心。
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