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左炔诺孕酮宫内节育器放置后母乳喂养的持续时间及儿童发育情况

Duration of breast-feeding and development of children after insertion of a levonorgestrel-releasing intrauterine contraceptive device.

作者信息

Heikkilä M, Luukkainen T

出版信息

Contraception. 1982 Mar;25(3):279-92. doi: 10.1016/0010-7824(82)90051-8.

Abstract

IUDs releasing levonorgestrel, 10 micrograms per day (30 patients) and 30 micrograms per day (40 patients), and copper-releasing IUDs (Nova-T) (40 patients) were inserted six weeks after delivery in 110 breast-feeding amenorrheic women. The infants were carefully followed-up by recording monthly weight gain and growth, age of eruption of the first tooth, age of being able to walk without support and morbidity to infective diseases. No differences were noticed between the study groups. Plasma samples were collected from 13 children at the age of eight months, while the mothers were breast-feeding. Six mothers had a levonorgestrel-releasing IUD and seven others the Nova-T or no hormonal or intrauterine contraceptive. No differences were noticed between the groups in Na, K, Cl, Ca, P, protein, albumin, creatinine, urate, Fe, cholesterol, triglyceride, bilirubin, alkaline phosphatase, aspargine aminotransferase, alanine aminotransferase, lactate-dehydrogenase or high density lipoprotein cholesterol serum concentrations in the children. The duration of breast-feeding and initiation of supplementary feeding was recorded. The continuation of breast-feeding 75 days after the insertion of a 30-micrograms per day levonorgestrel-releasing IUD was 56 percent while in the Nova-T group only 21 percent had discontinued which is a statistically significant difference (p less than 0.05); later the difference disappeared. Compared with the lactation time of their previous breast-feeding reported by women in both groups, the present lactation time increased by ten weeks. The infants received substitute foods including substitute milk, juices, etc., in the Nova-T group at 3.9 months and in the levonorgestrel-releasing IUD group at 3.4 months after delivery.

摘要

对110名哺乳期闭经的妇女在分娩六周后分别植入每日释放10微克左炔诺孕酮的宫内节育器(30例)、每日释放30微克左炔诺孕酮的宫内节育器(40例)以及含铜宫内节育器(Nova-T)(40例)。通过记录婴儿每月体重增加情况、生长发育、第一颗牙齿萌出的年龄、能够独立行走的年龄以及感染性疾病的发病率,对婴儿进行了仔细的随访。研究组之间未发现差异。在母亲进行母乳喂养期间,从13名八个月大的儿童中采集了血浆样本。其中六名母亲使用的是释放左炔诺孕酮的宫内节育器,另外七名母亲使用的是Nova-T宫内节育器或未使用任何激素或宫内避孕措施。两组儿童的钠、钾、氯、钙、磷、蛋白质、白蛋白、肌酐、尿酸、铁、胆固醇、甘油三酯、胆红素、碱性磷酸酶、天冬氨酸转氨酶、丙氨酸转氨酶、乳酸脱氢酶或高密度脂蛋白胆固醇血清浓度未发现差异。记录了母乳喂养的持续时间和开始添加辅食的时间。每日释放30微克左炔诺孕酮的宫内节育器植入75天后,母乳喂养的持续率为56%,而在Nova-T组中只有21%的母亲停止了母乳喂养,这一差异具有统计学意义(p<0.05);但之后这种差异消失了。与两组妇女之前报告的母乳喂养时间相比,此次母乳喂养时间增加了十周。Nova-T组婴儿在分娩后3.9个月开始接受包括代乳品、果汁等在内的替代食物,释放左炔诺孕酮的宫内节育器组婴儿在分娩后3.4个月开始接受。

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