背景:母乳喂养对母亲和婴儿有许多益处。乳发生II是实施母乳喂养的关键步骤之一。如果乳发生II在分娩后72小时以上,它被称为泌乳延迟发作(DOL)。DOL与牛奶产量下降有关,缩短母乳喂养时间,和病理性新生儿体重减轻。需要全面总结DOL的发生率和影响因素,为改善母乳喂养行为和健康结果提供依据。
方法:从13个中英文数据库(PubMed,Embase,WebofScience,科克伦图书馆,CINAHL,等。)从数据库开始到2023年8月。两名研究人员独立进行研究筛选,数据提取和质量评价。采用Stata16.0SE软件进行数据分析,并进行了敏感性分析和发表偏倚检验.使用定性描述方法对无法定量分析的研究进行分析。
结果:共有35项研究,涉及19,176名产妇,包括4922名患有DOL的人,包括在内。纳入研究的纽卡斯尔-渥太华量表平均得分为≥6分,表明质量相对较高。最后,DOL的发生率为30%,并获得了13个影响DOL的因素,结果稳健,没有发表偏倚:孕前体重指数(超重或肥胖),妊娠期糖尿病,妊娠期高血压,妊娠期甲状腺疾病,血清白蛋白水平(<35g/L),奇偶校验,(计划外)剖腹产,剖腹产史,每日睡眠持续时间,胎龄,出生体重(<2.5公斤),母乳喂养指导和每日母乳喂养频率。然而,仍有六个影响因素具有不确定的关联:年龄,妊娠期体重增加,出生体重(≥4公斤),焦虑,第一次母乳喂养的时间(产妇分离)和乳房按摩或治疗。
结论:DOL的发生率很高。临床医师应重视DOL高危产妇,根据其影响因素制定有针对性的预防策略,减少DOL的发生,促进母婴结局的改善。
背景:PROSPERO(ID:CRD42023458786),2023年9月10日。
BACKGROUND: Breastfeeding has many benefits for mothers and infants. Lactogenesis II is one of the key steps in the implementation of breastfeeding. If lactogenesis II occurs more than 72 h after delivery, it is termed delayed onset of lactation (DOL). DOL is associated with decreased milk production, shortened breastfeeding time, and pathological neonatal weight loss. A comprehensive summary of the incidence and factors influencing DOL is needed to provide a basis for improving breastfeeding practices and health outcomes.
METHODS: Studies on the incidence and factors influencing DOL were retrieved from 13 Chinese and English databases (PubMed, Embase, Web of Science, Cochrane Library, CINAHL, etc.) from database inception to August 2023. Two researchers independently conducted the study screening, data extraction and quality evaluation. Stata 16.0 SE software was used for data analysis, and sensitivity analysis and publication bias tests were also performed. The qualitative description method was used to analyse studies that could not be combined quantitatively.
RESULTS: A total of 35 studies involving 19,176 parturients, including 4,922 who had DOL, were included. The mean Newcastle‒Ottawa scale score of the included studies was ≥ 6, indicating that the quality was relatively high. Finally, the incidence of DOL was 30%, and 13 factors influencing DOL with robust results and no publication bias were obtained: prepregnancy body mass index (overweight or obesity), gestational diabetes, gestational hypertension, thyroid disease during pregnancy, serum albumin levels (< 35 g/L), parity, (unscheduled) caesarean section, caesarean section history, daily sleep duration, gestational age, birth weight (< 2.5 kg), breastfeeding guidance and daily breastfeeding frequency. However, there were still six influencing factors with undetermined associations: age, gestational weight gain, birth weight (≥ 4 kg), anxiety, time of first breastfeeding session (maternal separation) and breast massage or treatment.
CONCLUSIONS: The incidence of DOL is high. Clinicians should pay attention to parturients at high risk of DOL and formulate targeted prevention strategies according to the influencing factors to reduce the occurrence of DOL and promote better maternal and infant outcomes.
BACKGROUND: PROSPERO (ID: CRD42023458786), September 10, 2023.