农村妇女产后采用不同喂养婴儿方式对其体重变化的影响

目的 了解农村妇女生育后喂养方式与体重滞留的关系.方法 采用整群抽样的方法 ,调查天津市津南区409名农村产妇的孕产期情况,测量了孕前、产前及产后的体蕈和身高.产妇体重滞留值为调查时测量体重与孕前体重的差值.统计学方法 采用方差分析等.结果 (1)产后4个月内基本纯母乳喂养率为70.9%(290/409).(2)在产后4～6个月时基本纯母乳喂养组妇女的体重滞留平均为5.8 kg,比人工喂养组(平均7.0 kg)少,但差异没有统计学意义(F=1.45,P=0.236);而到产后7～9个月时基本纯母乳喂养组妇女的体重滞留平均为4.9 kg,显著高于人工喂养组的2.9 kg(F=3.17,P=0.043).(3)基本纯母乳喂养组产妇食物摄入量最多(901 g),其次是混合喂养组(877 g),人工喂养组最少(750 g).结论 妇女产后体重滞留与采用不同的喂养婴儿方式有关,进行母乳喂养婴儿的产妇因为需要摄取较多能量,产后体重恢复较慢,但是其孕期增重和产后体重都较人工喂养者轻.因此,在加强产后纯母乳喂养宣传的同时,也要加强孕前保健知识的宣传.     

不同喂养婴儿方式对产妇产后体重变化的影响

目的了解妇女生育后喂养方式对体重变化的影响。方法对孕期和产后4～6个月的孕产妇进行纵向追踪调查,记录体重变化情况。根据产妇在4个月内喂养婴儿的方式分为基本纯母乳喂养组、混合喂养组和人工喂养组。统计学方法采用重复测量数据的方差分析。结果产后4个月内基本纯母乳喂养率为63.8%(287/450)。人工喂养组的体重显著高于基本纯母乳喂养组(F组间=25.679,P<0.01),并且孕产妇的体重在不同的喂养方式下不同时间变化的趋势不同(F交互=22.321,P<0.01),基本纯母乳喂养组不同时间体重变化较稳定,人工喂养组不同时间体重变化幅度较大,说明人工喂养组孕期增重较多。结论进行母乳喂养婴儿的产妇因为需要摄取较多能量,产后体重恢复较慢,停止母乳喂养后,尤其是长期的体重恢复情况与人工喂养者的比较还有待于进一步研究。     

产后体重滞留影响因素的队列研究

目的探究女性产后体重滞留的影响因素。方法采用前瞻性队列研究,以在北京北方医院进行常规体检的产后1个月的女性为研究对象,进行5个月的追踪随访,调查研究对象的一般信息、孕前、分娩前、产后1个月、6个月的体重;在产后6个月,用半定量的食物频数法,收集研究对象的膳食摄入信息。利用单因素方差分析、χ~2检验、多元线性回归分析等统计学方法,探究影响产后体重滞留的因素结果孕前BMI 24.0 kg/m~2即孕前超重或肥胖者,产后1个月体重滞留约(6.4±5.5)kg,产后6个月,体重较孕前增加了(4.9±5.8) kg,均显著高于孕前BMI正常的女性;孕期增重过多,产后体重滞留程度大于孕期增重适宜以及孕期增重不足的女性(P0.05);当脂肪供能比超过推荐值时,产后1个月、6个月BMI明显增加(P0.05);多元线性回归分析后发现,孕期增重、产后6个月的喂养方式与产后体重滞留有关,孕期增重越多,产后6个月体重滞留越严重(β=0.73,P0.001);与母乳喂养相比,产后6个月混合喂养的女性,更容易发生产后体重滞留(β=0.16,P=0.027)。结论孕期增重、每天能量摄入、产后6个月的喂养方式会影响产后体重的恢复,孕期增重过多,每天能量摄入过高是产后6个月体重滞留的危险因素;而产后6个月母乳喂养(包括纯母乳喂养和以母乳喂养为主)是产后6个月体重滞留的保护因素,其中孕期增重是产后体重滞留最重要的预测因子。     

孕期增重以及产后软饮料的摄入对产后体重滞留的影响

目的 研究孕期增重以及产后膳食对产后体重滞留的影响 方法 采用队列研究的方法,以在北京北方医院进行产后复查的产妇为研究对象,分别在产后1个月、6个月进行追踪随访,调查研究对象的一般信息、孕前、分娩前、产后1个月、6个月的体重;用半定量的食物频数法,收集研究对象的膳食摄入信息。利用多元线性回归模型,分析孕期增重以及膳食摄入量与产后体重滞留的关系。结果 孕期增重（β = 0.73, 95%CI: 0.52～0.71,β = 0.67, 95%CI: 0.51～0.77）、软饮料摄入量（β = 0.14, 95%CI: 0.14～1.34,β = 0.15, 95%CI: 0.05～1.53）与产后1、6个月体重滞留呈正相关关系,关联具有统计学意义;按照喂养方式分层后,孕期增重、软饮料摄入与产后1个月、6个月喂养方式之间不存在交互作用。结论 孕期增重与产后软饮料摄入与产后体重滞留有关,与软饮料摄入量相比,孕期增重是产后体重滞留更重要的预测因子。     

孕期增重与产后1年内体重滞留的关系分析

目的探讨孕期增重对妇女产后1年内体重滞留的影响。方法采用前瞻性队列研究的方法选取在某妇幼保健机构参加体检的产妇作为观察对象,采用四分位数法对孕期增重进行分组,在产后3个月体检时发放问卷调查,调查表为自制问卷,建立观察队列。通过查找孕期保健手册和问卷调查获取基线资料和孕前体重。产后第3个月、第6个月、第9个月、第12个月通过体重秤测量获取产后体重。主要观察指标包括孕前体重、孕期增重和产后体重滞留。结果孕妇产后第3、6、9、12个月平均体重滞留值为(8.06±5.6)kg、(6.42±5.2)kg、(4.69±5.9)kg、(3.35±4.5)kg。孕期增重过多组产后3、6、9、12个月的体重滞留值均高于其他两组,差异有统计学意义。调整孕前BMI、身高、年龄因素后,多因素Logistic回归分析显示,孕期增重过多组产后第12个月体重滞留过多的危险性增加(OR=3.08,95%CI:1.78～5.33)。结论孕期增重与产后1年内的体重滞留有正相关性,孕妇应合理摄入营养,防止孕期增重过多,减少产后体重滞留,促进身心健康发展。     

产妇产后抑郁对婴儿喂养方式及婴儿体重的影响调查

目的 调查分析产妇产后抑郁对婴儿喂养方式及婴儿体重的影响,探讨产妇产后情绪干预对策,提升母婴健康。方法 选择2017年3月—2019年2月成都市第二人民医院分娩的80例符合纳入条件的孕妇为研究对象,采用爱丁堡产后抑郁量表(edinburgh postpartum depression scale,EPDS)于产后4周对产妇实施EPDS调查,EPDS评分≥13分产妇设为观察组(38例),EPDS评分＜13分产妇设为对照组(42例),分别于产后4周、8周、12周、16周跟踪收集两组产妇泌乳情况(泌乳量、母乳喂养次数)、喂养方式、新生儿体重情况并进行比较。结果 观察组产妇产后4周、8周、12周、16周泌乳量、母乳喂养次数均低于对照组(P＜0.05);观察组产后8周、12周、16周纯母乳喂养率均低于对照组(P＜0.05);观察组产后4周、8周、12周、16周婴儿体重增长重量均低于对照组(P＜0.05)。结论 产妇产后抑郁情绪降低产妇乳汁分泌量、喂养婴儿次数及纯母乳喂养率,降低婴儿体重增长速度,不利于婴儿健康成长,产前应加强孕妇情绪相关健康知识宣教,产后应加强产妇心理干预以降低产后抑郁症发生,提高母婴健康水平。     

喂养方式与婴儿生长发育及疾病的关系探讨

本研究旨在探讨不同喂养方式对婴儿的生长发育及疾病等的影响。将研究对象分为纯母乳喂养、混合喂养和人工喂养3组。根据阶段性体检要求进行婴儿3、6、9个月体检与随访,测量婴儿的体重、身长等指标并详细记录,填写婴儿营养及发育情况调查问卷。结果显示,6个月内婴儿体重、身高的发育指标,人工喂养组高于纯母乳喂养组和混合喂养组,以3个月婴儿尤为明显;到9个月时婴儿体重、身高指标三组差异均无统计学意义。但9个月内的婴儿患病率和患病次数以纯母乳喂养组最低(P<0.01)。因此,不同喂养方式与婴儿期生长发育以及疾病的发生密切相关,纯母乳喂养能更好地促进婴儿生长发育的增长需要,减少婴儿期疾病的发生。     

母乳喂养与婴儿生长发育状况的调查

目的 了解在我院出生的婴儿4个月内母乳喂养和生长发育状况。方法 对1998年10－12月出生婴儿的母亲用直接询问法。结果 满月婴儿、产后4个月婴儿母乳喂养率分别为76.83％、65.34%（扣除医学指征母乳喂养率分别为97.24%、81.71%）。纯母乳喂养组、混合喂养组、人工喂养组出生－产后4个月婴儿体重月均递增值分别为927.05、900.88和879.66g;身高月平均递增值分别为3.34、3.45、3.39cm。结论 母乳喂养组婴儿体重、身高递增值不低于人工喂养组。     

北京市妇女产后体重滞留的影响因素调查

目的探讨北京妇女产后体重滞留的影响因素。方法采用前瞻性队列研究方法,在北京市某妇幼保健院纳入待分娩孕妇420名,并于产后6、12和18个月进行追踪调查,观察指标包括一般情况、孕前体重、孕期增重和产后各调查时间点的体重。结果产后6、12和18个月的调查人数分别为113、152和107人。调查对象孕期增重平均为(16.6±4.8)kg,孕期增重不足、适量和过多的比例分别为9.5%、40.2%和50.3%。产后6、12和18个月体重滞留量分别为4 kg、4 kg和2.9 kg。孕前BMI和孕期增重与妇女产后体重滞留密切相关,孕前BMI越低,孕期增重越多,产后体重滞留越多。结论孕期增重过多是造成妇女产后体重滞留最重要的原因。     

母亲孕期增重及婴儿喂养方式与儿童肥胖的相关性分析

目的分析母亲孕期增重和婴儿的喂养方式与儿童肥胖之间的关系,为制定降低儿童肥胖率的相关措施提供参考。方法选取湖北省江陵县人民医院所在区域内的4家幼儿园中的951名儿童及其家长作为研究对象,采用问卷调查的方式对儿童及母亲的孕期情况进行调查。调查的内容包括:儿童的身高、体重、婴儿喂养方式等。采用单因素分析和多因素Logistic回归分析儿童肥胖与母亲孕期增重和婴儿喂养方式之间的关系。结果发放调查问卷951份,收回有效调查问卷940份,调查问卷的回收率为98.84%。受访儿童中肥胖的发生率为10.00%(94/940)。单因素分析结果表明,母亲孕期体重增加>15 kg的儿童肥胖发生率高于孕期体重增加未超过15 kg的儿童,差异有统计学意义(P<0.05),婴儿6个月内纯母乳喂养的儿童肥胖率低于未进行纯母乳喂养的儿童,差异有统计学意义(P<0.05)。Logistic回归分析显示,母亲孕期体重增加>15 kg是儿童肥胖的危险因素(P<0.05),婴儿6个月内纯母乳喂养是儿童肥胖的保护因素(P<0.05)。结论母亲孕期体重增加>15 kg和婴儿6个月内纯母乳喂养是儿童肥胖的影响因素,应引导孕妇适当控制体重增长,鼓励产妇采用纯母乳喂养婴儿,降低儿童肥胖发生率。     

产后返岗女性母乳喂养持续时间及其影响因素的研究

目的 调查产后返岗女性母乳喂养现况,探讨母乳喂养持续时间的影响因素。 方法 采用一般资料调查表、母乳喂养知识量表、IOWA 婴儿喂养态度量表、母乳喂养家庭支持问卷、母乳喂养支持的员工感知问卷对344名产后返岗女性进行调查,应用Cox回归探讨产后返岗女性母乳喂养持续时间的影响因素。 结果 产后返岗女性6个月纯母乳喂养率为38.7%;母乳喂养持续时间均值为10.07个月;Cox回归显示,家庭月收入、最小孩子年龄、IOWA婴儿喂养态度对母乳喂养持续时间有显著影响（P<0.05）。 结论 产后返岗女性6个月纯母乳喂养率较低,母乳喂养持续时间不容乐观,应重点关注经济水平较低的家庭,完善母乳喂养体系,保障持续母乳喂养的成功实现。     

Does infant feeding method influence maternal postpartum weight loss?

We conducted a retrospective study of 411 women to determine whether a significant relationship existed between method of infant feeding (breast vs bottle) and postpartum weight loss at 6 weeks and 12 months. In addition to method of infant feeding, the variables parity, gravidity, mode of delivery, maternal age, maternal prepregnancy weight, infant sex, and payment status (whether receiving assistance from the Aid to Dependent Children [ADC] program) were studied in terms of their association with weight loss. In general, no consistent relationship was found between method of infant feeding and postpartum weight loss. However, in the ADC group at 6 weeks and in the non-ADC group at 12 months, nonlactating women had lost more weight than had their lactating counterparts, in spite of the theoretical energy deficiency of breast-feeding women. Women who gained more weight during pregnancy consistently lost more weight following delivery, regardless of their prepregnancy weight. These results indicate that infant feeding method was not related to differences in postpartum weight loss between lactating and nonlactating counterparts.     

产后压力性尿失禁的危险因素及盆底功能锻炼的改善效果分析

目的:探讨产后压力性尿失禁(SUI)的危险因素及盆底功能锻炼的改善效果。方法:回顾性分析88例产后SUI产妇(失禁组)和同期分娩未发生SUI的80例健康产妇(对照组)临床资料。比较其年龄、孕龄、孕次、流产次数、体重指数(BMI)、经产情况、胎数、分娩方式、孕前或孕期合并尿失禁情况、吸烟情况、产后增加腹压、新生儿体重、产后盆底功能锻炼情况、孕期运动量、孕期泌尿系感染情况、新生儿喂养方式、母乳喂养时间等因素差异,经非条件logistic多元逐步回归分析影响产妇产后SUI的独立危险因素。按照实际治疗情况将88例失禁组产妇分为盆底功能锻炼组(38例)和未接受盆底功能锻炼组(50例),比较两组产妇治疗前后尿动力学指标,即最大尿道压(MUP)、最大尿流率(Qmax)、尿流时间(VT)等。结果:两组产妇年龄、孕龄、孕次、BMI、吸烟情况、孕期泌尿系感染情况、新生儿喂养方式、母乳喂养时间等一般资料比较均无统计学差异(P>0.05)。多元逐步回归分析显示,阴道分娩、孕前或孕期合并尿失禁、产后未予以盆底功能锻炼及新生儿体重≥4000g是影响产妇产后SUI发生的独立危险因素(P<0.05)。治疗后6、12个月时,失禁组中锻炼组产妇Qmax、MUP水平均较治疗前明显提高,且高于同期非锻炼组产妇(P<0.05);VT水平则较治疗前明显降低,且低于同期非锻炼组产妇(P均<0.05)。结论:阴道分娩、产后未行盆底功能锻炼、巨大儿及孕前或孕期合并尿失禁均同产后SUI的发生关系密切,建议产妇产后尽早接受盆底功能锻炼,以促进排尿功能恢复。     

Cesarean section and breastfeeding outcomes in an Indigenous Qom community with high breastfeeding support

Background and objectivesCesarean section may lead to suboptimal breastfeeding outcomes, though evidence has been mixed. Factors, such as premature birth, birth weight and maternal age may independently increase risk of cesarean and hinder breastfeeding initiation, while maternal preferences, support and sociostructural barriers may influence breastfeeding practices beyond the immediate postpartum period.MethodologyWe assessed impacts of cesarean section and gestational factors on breastfeeding duration among Indigenous Qom mothers in Argentina who have strong traditional breastfeeding support. We modeled transitions from exclusive breastfeeding to complementary feeding and from complementary feeding to full weaning in a Bayesian time-to-event framework with birth mode and gestational covariates (n = 89 infants).ResultsEstimated median time to full weaning was 30 months. Cesarean-delivered babies were weaned an average of 5 months later adjusting for gestational age, maternal parity and infant sex. No factors were associated with time-to-complementary feeding, and time-to-complementary feeding was not associated with time-to-full weaning.Conclusions and implicationsAmong Indigenous Qom mothers in Argentina, cesarean section was not associated with suboptimal breastfeeding outcomes. Although some Qom mothers do experience early breastfeeding problems, particularly following first birth, problems are not more frequent following cesarean delivery. Traditional postpartum kin and community support during prolonged postpartum periods may be instrumental in helping mothers to overcome early breastfeeding problems due to cesarean or other risk factors.     

Use of stable-isotope techniques to validate infant feeding practices reported by Bangladeshi women receiving breastfeeding counseling

BACKGROUND: The World Health Organization recommends exclusive breastfeeding until age 6 mo. Studies relying on mothers' self-reported behaviors have shown that lactation counseling increases both the rate and duration of exclusive breastfeeding. OBJECTIVE: We aimed to validate reported infant feeding practices in rural Bangladesh; intakes of breast milk and nonbreast-milk water were measured by the dose-given-to-the mother deuterium dilution technique. DESIGN: Subjects were drawn from the large-scale Maternal and Infant Nutrition Interventions, Matlab, study of combined interventions to improve maternal and infant health, in which women were randomly assigned to receive either exclusive breastfeeding counseling or standard health care messages. Data on infant feeding practices were collected by questionnaire at monthly visits. Intakes of breast milk and nonbreast-milk water were measured in a subsample of 98 mother-infant pairs (mean infant age: 14.3 wk) and compared with questionnaire data reporting feeding practices. RESULTS: Seventy-five of the 98 subjects reported exclusive breastfeeding. Mean (+/-SD) breast milk intake was 884 +/- 163 mL/d in that group and 791 +/- 180 mL/d in the group reported as nonexclusively breastfed (P = 0.0267). Intakes of nonbreast-milk water were 40 +/- 80.6 and 166 +/- 214 mL/d (P < 0.0001), respectively. Objective cross-validation using deuterium dilution data showed good accuracy in reporting of feeding practices, although apparent misreporting was widely present in both groups. CONCLUSIONS: The dose-given-to-the-mother deuterium dilution technique can be applied to validate reported feeding behaviors. Whereas this technique shows that the reports of feeding practices were accurate at the group level, it is not adequate to distinguish between feeding practices in individual infants.     

Perinatal factors influencing infant feeding practices at birth: the Bedouin Infant Feeding Study

Bedouin Arab women delivering newborns at Soroka Medical Center, Israel, during 1 year were interviewed in hospital to determine the factors influencing infant feeding practices at birth. Eighty-six per cent breastfed, 11% breast and bottlefed, and 3% bottlefed at birth. Based on a multiple logistic regression analysis, the factors that significantly reduced the odds ratio (OR) of exclusive breastfeeding vs. breast and bottle feeding or bottle feeding at birth include: delivering during the high birth season (OR = 0.49); maternal recall of feeling unwell during pregnancy (OR = 0.59); delivering a low birthweight newborn (OR = 0.10); a newborn diagnosed with major malformations (OR = 0.30) or with major illnesses (OR = 0.32); and delivering by Caesarean section (OR = 0.09). In contrast, multiparae experienced an increased odds (OR = 1.67) of breastfeeding. Among primiparae, the factors that significantly reduced the odds of exclusive breastfeeding include: delivering during the high birth season (OR = 0.47); delivering a low birthweight newborn (OR = 0.12); and delivering by Caesarean section (OR = 0.18). Mothers of high-risk neonates and those who deliver by Caesarean section need to be educated about the benefits of exclusive breastfeeding. Young primiparae are a challenge and require qualitative and quantitative research into the reasons precluding exclusive breastfeeding.     

Perinatal factors influencing infant feeding practices at birth: the Bedouin Infant Feeding Study

Summary. Bedouin Arab women delivering newborns at Soroka Medical Center, Israel, during 1 year were interviewed in hospital to determine the factors influencing infant feeding practices at birth. Eighty-six per cent breastfed, 11% breast and bottlefed, and 3% bottlefed at birth. Based on a multiple logistic regression analysis, the factors that significantly reduced the odds ratio (OR) of exclusive breastfeeding vs. breast and bottle feeding or bottle feeding at birth include: delivering during the high birth season (OR = 0.49); maternal recall of feeling unwell during pregnancy (OR = 0.59); delivering a low birthweight newborn (OR = 0.10); a newborn diagnosed with major malformations (OR = 0.30) or with major illnesses (OR = 0.32); and delivering by Cae-sarean section (OR = 0.09). In contrast, multiparae experienced an increased odds (OR = 1.67) of breastfeeding. Among primiparae, the factors that significantly reduced the odds of exclusive breastfeeding include: delivering during the high birth season (OR = 0.47); delivering a low birthweight newborn (OR = 0.12); and delivering by Caesarean section (OR = 0.18). Mothers of high-risk neonates and those who deliver by Caesarean section need to be educated about the benefits of exclusive breastfeeding. Young primiparae are a challenge and require qualitative and quantitative research into the reasons precluding exclusive breastfeeding.     

北京市323例1~<2月龄婴儿身长体重发育及喂养方式状况分析

目的了解1~<2月龄婴儿身长体重发育状况及不同喂养方式间婴儿体格发育的差异,为做好儿童保健工作提供参考。方法使用在北京市某城区医院出生、并于2017年8月-2019年7月来医院进行出生后1~<2月龄健康检查的婴儿体检资料,对婴儿的体重和身长,以及喂养方式数据进行分析。用t检验方法,分析不同性别间及不同喂养方式间婴儿体重身长的差异。结果在323名婴儿中,完全母乳喂养率为59.4%,男女婴儿完全母乳喂养率差异无统计学意义(χ^2=3.321,P=0.190)。男孩1~<2月龄时的体重身长,以及生后至1~<2月龄的体重身长增长值均明显高于女孩相应的体重身长和体重身长的增长值,差异有统计学意义(P<0.05)。男女婴儿完全母乳喂养组1~<2月龄时的体重及体重增长值均明显高于非完全母乳喂养组的体重和体重增长值,差异有统计学意义(P<0.05)。结论母乳喂养有利于婴儿体格发育,母乳喂养率尚低。应进一步加强促进母乳喂养的措施,提高母乳喂养率。     

上海市0~6月龄婴儿母亲纯母乳喂养知信行调查

目的 了解上海市0~6月龄婴儿母亲纯母乳喂养知信行现状。方法 全覆盖问卷调查全市0~6月龄婴儿母亲共5 672名,排除仅进行人工喂养者后进行纯母乳知识、态度和行为情况调查。结果 0~6月龄婴儿纯母乳喂养率为51.34%,与混合喂养组相比,纯母乳喂养组在"正常6个月以内的婴儿食物"（χ2=10.02,P=0.002）和"对婴儿配方奶的看法"（χ2=21.30,P<0.001）等2项母乳喂养知识知晓率、纯母乳喂养信心（χ2=544.57,P<0.001）、母乳喂养方式（χ2=164.97,P<0.001）和维持泌乳方式（χ2=479.33,P<0.001）方面差异有统计学意义。希望通过门诊咨询（母乳喂养咨询室）获得母乳喂养支持的比例最高（56.11%）。结论 纯母乳喂养者的认知、态度和行为较混合喂养者更科学,应开展专业、有效的健康教育,提高纯母乳喂养率。