围生期综合干预对妊娠期糖尿病妇女母乳喂养的影响
摘要
目的探讨围生期个性化综合干预对妊娠期糖尿病(GDM)妇女母乳喂养的影响,为围生期采取综合干预措施提高GDM妇女母乳喂养率提供参考依据。方法采用随机对照试验,将2017年7月-10月在四川大学华西第二医院待产的GDM孕妇随机分为干预组(107例)和对照组(105例),干预组进行入院评估并制定个性化措施,进行一对一、面对面干预、产后综合干预、出院前知识强化的干预措施,对照组进行常规喂养指导,比较出院时两组母乳喂养、知识知晓、自我效能。结果入院时两组研究对象基线资料差异无统计学意义(均P>0. 05);出院时干预组纯母乳喂养率(27. 00%)高于对照组(13. 33%),差异有统计学意义(P<0. 05),母乳喂养相关知识得分(111. 64±9. 03)分高于对照组(107. 39±9. 21)分,差异有统计学意义(P<0. 05),干预组母乳喂养自我效能的内心维度、技能维度、总分均高于对照组,差异有统计学意义(均P<0. 05)。结论采用围生期个性化综合干预可以显著提高GDM妇女的纯母乳喂养率、改善相关知识知晓情况以及母乳喂养自信心。
引文
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[13]曾丽春,巫兰芬,钟丽清.健康教育干预对母乳喂养成功的影响[J].吉林医学,2010,31(8):1103-1104.
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[18]Lumbiganon P,Martis R,Laopaiboon M,et al.Antenatal breastfeeding education for increasing breastfeeding duration[J].Cochrane Database Syst Rev,2012,12(9):CD006425.
[2]Lee AJ,Hiscock RJ,Wein P.Gestational diabetes mellitus:Clinical prediction and long-term risk of developing type 2 diabetes:Aretrospective cohort study using survival analysis[J].Diabetes Care,2007,30:878-883.
[3]Dijigow FB,Paganoti Cde F,Costa RA,et al.The influence of breastfeeding in postpartum oral glucose tolerance test in women with recent gestational diabetes mellitus[J].Medline,2015,37(12):565-570.
[4]Simmons D,Conroy C,Thompson CF.In-hospital breast feeding rates among women with gestational diabetes and pregestational Type 2diabetes in South Auckland[J].Diabet Med,2005,22(2):177-181.
[5]Hirst JE,Thach Son T,Myan Thi D,et al.Women with gestational diabetes in Vietnam:a qualitative study to determine attitudes and health behaviours[J].BMC Pregnancy Child,2012,12(9):81.
[6]Bromiker R,Rachamim A,Hammerman C.Immature sucking patterns in infants of mothers with diabetes[J].Pediatr,2006,149(5):640-643.
[7]Dewey KG,Nommsen-Rivers LA,Heinig MJ.Risk factors for suboptimal infant breastfeeding behavior,delayed onset of lactation,and excess neonatal weight loss[J].Pediatrics,2003,112:607-619.
[8]Morrison MK,Collins CE,Lowe JM,et al.Factors associated with early cessation of breastfeeding in women with gestational diabetes mellitus[J].Diabet Med,2014,31(10):1222-1229.
[9]郭慧洁,王吉平,徐倩倩.妊娠期糖尿病患者产后母乳喂养的研究进展[J].护理学杂志,2015,30(24):99-102.
[10]赵旻.北京地区初产妇母乳喂养自我效能及其影响因素的研究[D].北京:中国协和医科大学,2008.
[11]姜晨.增强自我效能的产前母乳喂养健康教育对母乳喂养的影响研究[D].南京:南京中医药大学,2015.
[12]Gunderson EP.The role of lactation in GDM women[J].Clin Obstet Gynecol,2013,76(4):844-852.
[13]曾丽春,巫兰芬,钟丽清.健康教育干预对母乳喂养成功的影响[J].吉林医学,2010,31(8):1103-1104.
[14]Zhang J,Shi L,Chen D,et al.Using the theory of planned behavior to examine effectiveness of an educational intervention on infant feeding in China[J].Prev Med,2009,49(6):529-534.
[15]Dunn S,Davies B,Mc Cleary L.The relationship between vulnerability factors and breastfeeding outcome[J].J Obstet Gynecol Neonatal Nurs,2006,35(1):87-97.
[16]Mcfadden A,Gavine A,Renfrew MJ,et al.Support for healthy breastfeeding mothers with healthy term babies[J].Cochrane Database Syst Rev,2017,28(2):CD001141.
[17]朱毓,万宏伟,黄蓉.产后六个月的母乳喂养干预进展[J].上海交通大学学报(医学版),2013,33(8):1176-1180.
[18]Lumbiganon P,Martis R,Laopaiboon M,et al.Antenatal breastfeeding education for increasing breastfeeding duration[J].Cochrane Database Syst Rev,2012,12(9):CD006425.