Chinese General Practice ›› 2022, Vol. 25 ›› Issue (18): 2268-2274.DOI: 10.12114/j.issn.1007-9572.2022.0070

• Original Research • Previous Articles     Next Articles

Maternal Physical Activity in the Third Trimester and Delayed Onset of Lactogenesis

  

  1. 1. School of Nursing, Anhui Medical Univeisity, Hefei 230601, China
    2. Obstetric Department, 901 Hospital, Joint Logistic Support Force of the Chinese People's Liberation Army, Hefei 230071, China
    3. Lianyungang Maternal and Child Health Care Hospital, Lianyungang 222000, China
  • Received:2022-01-22 Revised:2022-02-28 Published:2022-06-20 Online:2022-03-24
  • Contact: Yuhong LI
  • About author:
    ZHAO J J, LI Y H, YU M, et al. Maternal physical activity in the third trimester and delayed onset of lactogenesis[J]. Chinese General Practice, 2022, 25 (18) : 2268-2274. ZHAO Jingjing, ORCID: 0000-0002-1274-9006 LI Yuhong, ORCID: 0000-0002-4170-2039

妊娠晚期孕妇体力活动对泌乳启动延迟的影响研究

  

  1. 1.230601 安徽省合肥市,安徽医科大学护理学院
    2.230071 安徽省合肥市,中国人民解放军联勤保障部队第901医院产科
    3.222000 江苏省连云港市妇幼保健院
  • 通讯作者: 李玉红
  • 作者简介:
    注:赵晶晶,ORCID:0000-0002-1274-9006 李玉红,ORCID:0000-0002-4170-2039 赵晶晶,李玉红,俞敏,等.妊娠晚期孕妇体力活动对泌乳启动延迟的影响研究[J].中国全科医学,2022,25(18):2268-2274. [www.chinagp.net] 作者贡献:赵晶晶提出研究的目的及主要指标,进行研究的设计及文章的构思、数据分析、论文的撰写与修订;俞敏负责研究的质量控制及文章的审校;杨方方、俞巧稚、汪小月、卜丝丝、廖培培进行资料收集、整理与数据管理,负责绘制表格;李玉红负责研究的总体设计、质量控制、监督管理以及文章审校,并对文章整体负责。所有作者确认论文终稿。
  • 基金资助:
    安徽省自然科学基金面上项目(2108085MG242); 院青年英才培养基金(KY202108); 安徽医科大学护理学院科研基金培育项目(hlqm2021006)

Abstract:

Background

Delayed onset of lactogenesis (DOL) is an important cause of failed lactation. Excessive gestational weight gain and postpartum depression will increase the risk of DOL, but appropriate physical activity (PA) during pregnancy may effectively prevent excessive gestational weight gain, improve postpartum negative mood, benefiting breastfeeding. However, the relationship between PA during pregnancy and DOL is still unclear.

Objective

To investigate the PA level in the third trimester and its association with DOL, providing a basis for early prevention of DOL and ensuring breastfeeding success.

Methods

A prospective study design was adopted. Participants were women in their third trimester who underwent prenatal examination and later delivery in the 901 Hospital, Joint Logistic Support Force of the Chinese People's Liberation Army, from December 2020 to August 2021. General information (including demographic and obstetric data) , PA and sedentary behaviour time (evaluated by the International Physical Activity Questionnaire-Short Form) , postpartum depression (evaluated by the Edinburgh Postnatal Depression Scale) , and DOL were investigated and collected. Unconditional Logistic regression analysis was used to explore the relationship between PA level in the third trimester and DOL.

Results

A total of 261 cases were selected, and 247 of them (94.7%) who returned responsive questionnaires were finally enrolled. The prevalence of DOL was 27.9% (69/247) . Respondents with and without DOL had significant differences in gestational weight gain, depression prevalence, and prevalence of infant formula feeding within 48 hours after delivery (P<0.1) . The prevalence of having appropriate and inappropriate PA in the third trimester was 73.3% (181/247) and 26.7% (66/247) , respectively. The prevalence of duration of sedentariness ≥6.5 h/d was 15.8% (39/247) . Respondents with DOL had lower prevalence of having appropriate PA, and higher prevalence of duration of sedentariness ≥6.5 h/d than did those without (P<0.05) . Unconditional Logistic regression analysis showed that inappropriate PA level 〔OR=0.421, 95%CI (0.223, 0.797) 〕 and longer duration of sedentariness ≥6.5 h/d〔OR=0.193, 95%CI (0.090, 0.414) 〕 in the third trimester were associated with increased risk of DOL (P<0.05) .

Conclusion

Inappropriately increasing the level of PA during pregnancy and reducing the duration of sedentariness per day could reduce the risk of DOL and effectively improve the rate of successful breastfeeding.

Key words: Lactation, Delayed onset of lactogenesis, Pregnant women, Pregnancy trimester, third, Physical exertion, Sedentary behavior, Root cause analysis

摘要:

背景

泌乳启动延迟(DOL)是造成母乳喂养失败的一个重要原因,妊娠期增重过多、产后抑郁会增加产后DOL的发生风险,而妊娠期体力活动(PA)可以有效防止体质量增加过多,改善产后负性情绪,有益于母乳喂养,但目前妊娠期PA与DOL的关系尚不明确。

目的

探讨妊娠晚期孕妇PA现状及对DOL的影响,为早期预防DOL,保障母乳喂养提供依据。

方法

采取前瞻性研究设计,取2020年12月至2021年8月在中国人民解放军联勤保障部队第901医院产检并分娩的妊娠晚期孕妇作为研究对象。调查并收集孕妇的一般资料(包括人口学资料和产科资料)、PA和久坐行为(SB)时间(采用国际体力活动短问卷评价)、产后抑郁(采用爱丁堡产后抑郁量表评价)及DOL情况。采用非条件Logistic回归分析探究妊娠晚期孕妇PA水平和DOL的关系。

结果

共发放调查问卷261份,回收有效问卷247份,有效回收率为94.7%。247例孕妇中69例(27.9%)发生DOL。DOL产妇和非DOL产妇妊娠期增重、分娩后48 h内添加配方奶粉、抑郁情绪情况比较,差异有统计学意义(P<0.1)。247例孕妇中妊娠晚期PA充足者181例(73.3%),不充足者66例(26.7%);15.8%(39/247)的孕妇的SB时间≥6.5 h/d。DOL产妇PA水平充足发生率低于非DOL组,SB时间≥6.5 h/d发生率高于非DOL产妇(P<0.05)。非条件Logistic回归分析结果显示,PA水平〔不充足:OR=0.421,95%CI(0.223,0.797)〕、SB时间〔≥6.5 h/d:OR=0.193,95%CI(0.090,0.414)〕是孕妇DOL的影响因素(P<0.05)。

结论

提高妊娠期PA水平、减少SB时间有助于减少DOL的发生,有效提高母乳喂养率。

关键词: 泌乳, 泌乳启动延迟, 孕妇, 妊娠末期, 体力活动, 久坐生活方式, 影响因素分析