Michel S H, Mueller D H
Department of Pediatrics and a nutritionist in the Cystic Fibrosis Center, Hahnemann University, Philadelphia, PA 19102.
J Am Diet Assoc. 1994 Feb;94(2):159-65. doi: 10.1016/0002-8223(94)90240-2.
To evaluate the impact of lactation on the health status of women with cystic fibrosis and their infants.
Data were acquired through a retrospective review of pulmonary, obstetric, and pediatric medical records.
A medical school-based Pediatric Cystic Fibrosis Center in Philadelphia, Pa.
Five women with cystic fibrosis and their respective infants.
For the women, measures of pregravid, gravid, and postpartum height, weight, pulmonary function test results, and energy intake were determined. For the infants, birth Apgar scores were obtained, as were measures of growth and development.
Means and standard deviations were calculated. Data were compared with published standardized references.
Mean maternal age at conception was 25.4 +/- 4.1 years. Mean pregravid weight was 60.0 +/- 10.7 kg of standard body weight for height (range = 50.8 to 76.7 kg; median = 58 kg). Two women consumed up to two enteric-coated supplemental enzyme capsules per meal, three women consumed none. Pulmonary disease was mild in four of the five women. Mean weight gain during pregnancy was 10.2 +/- 7.4 kg. Mean gestation was 37.4 +/- 1.5 weeks; mean birth weight was 3.0 +/- 0.5 kg. Sweat tests performed on all infants were negative. Duration of breast-feeding was 3 to 30 weeks. Four of the five infants maintained appropriate growth velocity during breast-feeding. Mean maternal energy intake during lactation was above the Recommended Dietary Allowance for lactating women. Four of the five women were at or above their standard body weight during lactation.
CONCLUSIONS/APPLICATIONS: We conclude that women with the clinical diagnosis of mild cystic fibrosis disease can maintain a normal pregnancy with appropriate weight gain and can deliver infants of normal weight for gestational age. During lactation, women with mild cystic fibrosis disease can maintain their own weight and support growth in healthy infants. The dietitian needs to be an integral member of the health care team in assessing, monitoring, and managing women with cystic fibrosis during their child-bearing years.
评估哺乳期对患有囊性纤维化的女性及其婴儿健康状况的影响。
通过回顾肺部、产科和儿科医疗记录获取数据。
宾夕法尼亚州费城一所医学院附属的儿科囊性纤维化中心。
五名患有囊性纤维化的女性及其各自的婴儿。
对于这些女性，测定孕前、孕期和产后的身高、体重、肺功能测试结果以及能量摄入。对于婴儿，获取出生时的阿氏评分以及生长发育指标。
计算均值和标准差。将数据与已发表的标准化参考数据进行比较。
受孕时母亲的平均年龄为25.4±4.1岁。孕前平均体重为身高对应的标准体重的60.0±10.7千克（范围=50.8至76.7千克；中位数=58千克）。两名女性每餐服用多达两粒肠溶补充酶胶囊，三名女性未服用。五名女性中有四名的肺部疾病较轻。孕期平均体重增加10.2±7.4千克。平均妊娠期为37.4±1.5周；平均出生体重为3.0±0.5千克。对所有婴儿进行的汗液测试均为阴性。母乳喂养持续时间为3至30周。五名婴儿中有四名在母乳喂养期间保持了适当的生长速度。哺乳期母亲的平均能量摄入高于哺乳期妇女的推荐膳食摄入量。五名女性中有四名在哺乳期达到或超过其标准体重。
结论/应用：我们得出结论，临床诊断为轻度囊性纤维化疾病的女性可以维持正常妊娠，体重适当增加，并能分娩出符合孕周的正常体重婴儿。在哺乳期，轻度囊性纤维化疾病的女性可以维持自身体重并支持健康婴儿的生长。营养师需要成为医疗团队中不可或缺的一员，在育龄期患有囊性纤维化的女性的评估、监测和管理中发挥作用。
