母婴皮肤接触时长对妊娠糖尿病产妇新生儿血糖及母乳喂养的影响

李晓芬; 徐萌艳; 徐捷; 吴清清

doi:10.16766/j.cnki.issn.1674-4152.003554

母婴皮肤接触时长对妊娠糖尿病产妇新生儿血糖及母乳喂养的影响

doi: 10.16766/j.cnki.issn.1674-4152.003554

杭州市妇产科医院产科，浙江杭州 310008

基金项目:

浙江省医药卫生科技计划项目 2023KY204

详细信息

通讯作者:
李晓芬，E-mail：lbhz0712@163.com

中图分类号: R714.256R722
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- 文章访问数: 133
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- PDF下载量: 4
- 被引次数: 0
出版历程
- 收稿日期: 2023-11-09
- 网络出版日期: 2024-07-22

Effect of mother-infant skin contact duration on blood glucose and breast feeding of newborns of diabetic mother

Department of Obstetrics, Hangzhou Women' s Hospital, Hangzhou, Zhejiang 310008, China

摘要

摘要: 目的探讨延长母婴皮肤接触持续时间对改善妊娠糖尿病(GDM)产妇新生儿血糖水平、维持体温稳定性及促进母乳喂养的效果。方法选取2023年2—4月在杭州市妇产科医院自然分娩的90例妊娠糖尿病产妇足月分娩新生儿为研究对象，采用随机数字表法分为观察组(45例，新生儿出生后母婴皮肤接触持续90 min)和对照组(45例，母婴皮肤接触持续30 min)。比较2组新生儿出生即刻、出生30 min、90 min、2 h时的体温、血糖水平及母乳喂养情况。结果观察组新生儿出生90 min、2 h时体温均高于对照组(P＜0.05)；观察组新生儿出生90 min、2 h时血糖值均高于对照组(P＜0.05)；观察组出生2 h低血糖发生率为2.22%(1/45)，低于对照组的15.56(7/45)，但差异无统计学意义(χ²=3.430，P＞0.05)。观察组新生儿首次母乳喂养成功率、吸吮持续时间及母乳喂养量表得分均高于对照组(P＜0.05)。结论妊娠糖尿病产妇新生儿出生后给予持续90 min的母婴皮肤接触有利于维持新生儿血糖和体温的稳定，促进纯母乳喂养。
- 妊娠糖尿病 /
- 皮肤接触 /
- 新生儿 /
- 血糖 /
- 母乳喂养
Abstract: Objective To explore the effects of extended mother-infant skin contact on improving blood sugar levels in newborns of mothers with diabetes mellitus (GDM), stabilizing body temperature, and promoting breast feeding. Methods A total of 90 full-term newborns of diabetic pregnant women who gave birth naturally in Hangzhou Women' s Hospital from February to April 2023 were selected for this study. The newborns were randomly divided into an observation group (45 cases, 90-min skin contact) and a control group (45 cases, 30-min skin contact). The body temperature, blood glucose levels, and breastfeeding status of two groups were compared at birth, 30 minutes, 90 minutes, and 2 hours. Results The body temperature of newborns in the observation group were higher than that in the control group at 90 minutes and 2 hours of birth (P < 0.05). The blood glucose levels of newborns in the observation group were also higher than those in the control group at these times (P < 0.05). The incidence of 2-hour hypoglycemia in the observation group was 2.22% (1/45), lower than the control group (15.56%, 7/45), but the difference was not statistically significant (χ²=3.430, P > 0.05). The success rate of the first breastfeeding, duration of sucking, and the breastfeeding scale scores of newborns in the observation group were higher than those in the control group (P < 0.05). Conclusion Ninety minutes of mother-infant skin contact after birth for newborns of diabetic mothers is conducive to maintaining the stability of blood sugar and temperature of newborns, and promoting exclusive breastfeeding.
- Gestational diabetes /
- Skin contact /
- Newborns /
- Blood glucose /
- Breast feeding

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表 1 2组GDM产妇及新生儿一般资料比较

Table 1. Comparison of general information between two groups of GDM mothers and newborns

项目	观察组(n=45)	对照组(n=45)	统计量	P值
产妇年龄(x ± s, 岁)	30.45±3.18	31.30±3.75	1.160^a	0.249
分娩孕周(x ± s, 周)	39.10±2.11	39.38±2.40	0.587^a	0.558
产次[例(%)]			0.413^b	0.520
初产妇	28(62.22)	25(55.56)
经产妇	17(37.78)	20(44.44)
总产程(x ± s, min)	483.7±209.2	519.3±218.6	0.787^a	0.433
产妇空腹血糖(x ± s, mmol/L)	5.59±0.83	5.47±0.79	0.703^a	0.484
产妇餐后2 h血糖(x ± s, mmol/L)	7.30±0.96	7.15±0.91	0.761^a	0.449
破膜时间[例(%)]			1.353^b	0.245
＜12 h	40(88.89)	36(80.0)
≥12 h	5(11.11)	9(20.0)
产时发热[例(%)]	4(8.89)	3(6.67)	0.155^b	0.694
产时出血量(x ± s, mL)	279.5±101.3	301.7±125.0	0.926^a	0.357
无痛分娩[例(%)]	27(60.0)	29(64.44)	0.189^b	0.664
新生儿体重(x ± s, g)	3 383.7±326.5	3 411.5±330.6	0.401^a	0.689
新生儿1 min Apgar评分(x ± s, 分)	9.93±0.30	9.91±0.20	0.372^a	0.711
注：^a为t值，^b为χ²值。

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表 2 2组新生儿不同时间点体温比较(x ± s, ℃)

Table 2. Comparison of body temperature within 2 hours of birth between two groups of newborns(x ± s, ℃)

组别	例数	出生时	出生30 min	出生90 min	出生2 h	F值	P值
观察组	45	36.40±0.22	36.46±0.17	36.53±0.18^a	36.60±0.20^a	9.008	＜0.001
对照组	45	36.43±0.25	36.48±0.21	36.27±0.20^a	36.15±0.22^a	21.069	＜0.001
F值		0.332	0.511	6.048	10.153
P值		0.705	0.610	0.001	＜0.001
注：与同组出生时比较，^aP＜0.05。

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表 3 2组新生儿母乳喂养情况比较

Table 3. Comparison of Breastfeeding Conditions between Two Groups of Newborns

组别	例数	首次母乳喂养成功[例(%)]	吸吮持续时间(x ± s, min)	母乳喂养量表得分(x ± s, 分)
观察者	45	42(93.33)	21.40±4.92	10.16±1.45
对照组	45	31(68.89)	10.36±4.50	7.99±2.08
统计量		8.775^a	11.107^b	5.741^b
P值		0.003	＜0.001	0.001
注：^a为χ²值，^b为t值。

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表 4 2组新生儿不同时间点血糖水平比较(x ± s, mmol/L)

Table 4. Comparison of blood glucose levels within 2 hours of birth between two groups of newborns(x ± s, mmol/L)

组别	例数	出生时	出生30 min	出生90 min	出生2 h	F值	P值
观察组	45	4.23±0.74	3.78±0.79	3.67±0.63	3.95±0.70^b	5.501	0.001
对照组	45	4.26±0.83	3.82±0.95^a	3.31±0.86^a	3.16±0.79^a	13.889	＜0.001
F值		0.181	0.216	2.265	5.021
P值		0.856	0.829	0.026	0.001
注：与同组出生时比较，^aP＜0.05；与同组出生90 min时比较，^bP＜0.05。

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参考文献(15)

[1]	金鑫, 吴艳. 妊娠期糖尿病并发脂代谢紊乱的危险因素[J]. 现代妇产科进展, 2021, 30(6): 426-429. https://www.cnki.com.cn/Article/CJFDTOTAL-XDFC202106007.htm JIN X, WU Y. Risk factors of gestational diabetes mellitus complicated with lipid metabolism disorder[J]. Progress in Obstetrics and Gynecology, 2021, 30(6): 426-429. https://www.cnki.com.cn/Article/CJFDTOTAL-XDFC202106007.htm
[2]	SHAH R, HARDING J, BROWN J, et al. Neonatal glycaemia and neurodevelopmental outcomes: a systematic review and meta-analysis[J]. Neonatology, 2019, 115(2): 116-126. doi: 10.1159/000492859
[3]	马芬芳, 李小玲, 刘玉嫦, 等. 妊娠期糖尿病产妇新生儿血糖变化的相关因素分析[J]. 国际医药卫生导报, 2022, 28(8): 1147-1149. doi: 10.3760/cma.j.issn.1007-1245.2022.08.026 MA F F, LI X L, LIU Y C, et al. Study on the related factors of blood glucose change in newborns born to women with gestational diabetes mellitus[J]. International Medicine and Health Guidance News, 2022, 28(8): 1147-1149. doi: 10.3760/cma.j.issn.1007-1245.2022.08.026
[4]	李珍. 母婴皮肤接触时间对新生儿体温和血糖的影响研究[J]. 护理与康复, 2022, 21(1): 34-36. doi: 10.3969/j.issn.1671-9875.2022.01.008 LI Z. Study on the effect of maternal and infant skin contact time on neonatal body temperature and blood glucose[J]. Journal of Nursing and Rehabilitation, 2022, 21(1): 34-36. doi: 10.3969/j.issn.1671-9875.2022.01.008
[5]	林蓉金, 金调芬, 孙欣悦. 母婴皮肤早接触对妊娠期糖尿病产妇新生儿血糖的影响[J]. 中国妇幼保健, 2019, 34(11): 2507-2509. https://www.cnki.com.cn/Article/CJFDTOTAL-ZFYB201911029.htm LIN R J, JIN T F, SUN X Y. Effects of early maternal and infant skin contact on neonatal blood glucose in pregnant women with gestational diabetes[J]. China Maternal and Child Health, 2019, 34(11): 2507-2509. https://www.cnki.com.cn/Article/CJFDTOTAL-ZFYB201911029.htm
[6]	明亚琼, 庞平, 曹婷, 等. 新生儿低血糖的危险因素分析[J]. 贵州医科大学学报, 2021, 46(9): 1096-1100. https://www.cnki.com.cn/Article/CJFDTOTAL-GYYB202109019.htm MING Y Q, PANG P, CAO T, et al. Analysis of risk factors for neonatal hypoglycemia[J]. Guizhou Medical University Newspaper, 2021, 46(9): 1096-1100. https://www.cnki.com.cn/Article/CJFDTOTAL-GYYB202109019.htm
[7]	林雪芳, 谢溢婷. 母婴皮肤接触持续时间对新生儿体温及母乳喂养的影响[J]. 河南医学高等专科学校学报, 2023, 35(1): 86-89. https://www.cnki.com.cn/Article/CJFDTOTAL-HNZG202301022.htm LIN X F, XIE Y T. Effect of duration of maternal and infant skin contact on neonatal body temperature and breastfeeding[J]. Journal of Henan Medical College, 2023, 35(1): 86-89. https://www.cnki.com.cn/Article/CJFDTOTAL-HNZG202301022.htm
[8]	COOIJMANS K H M, BEIJERS R, DE WEERTH C. Daily skin-to-skin contact and crying and sleeping in healthy full-term infants: a randomized controlled trial[J]. Dev Psychol, 2022, 58(9): 1629-1638. doi: 10.1037/dev0001392
[9]	TAKAHASHI Y, TAMAKOSHI K. The positive association between duration of skin-to-skin contact and blood glucose level in full-term infants[J]. J Perinat Neonatal Nurs, 2018, 32(4): 351-357. doi: 10.1097/JPN.0000000000000335
[10]	夏婧男, 邵海珍. 乳房爬行运动对新生儿早期自主觅乳和母乳喂养的影响[J]. 中国妇幼保健, 2022, 37(19): 3586-3589. https://www.cnki.com.cn/Article/CJFDTOTAL-ZFYB202219027.htm XIA J N, SHAO H Z. Effect of breast crawling exercise on autonomous breast seeking and breastfeeding in early newborn infants[J]. China Maternal and Child Health, 2022, 37(19): 3586-3589. https://www.cnki.com.cn/Article/CJFDTOTAL-ZFYB202219027.htm
[11]	崔敏, 田晓明, 王爱华, 等. 皮肤接触中新生儿寻乳行为表达及影响因素研究[J]. 中国儿童保健杂志, 2020, 28(1): 28-31. https://www.cnki.com.cn/Article/CJFDTOTAL-ERTO202001011.htm CUI M, TIAN X M, WANG A H, et al. Sequence expression of neonatal breast-seeking behavior and its influencing factors during skin-to-skin contact[J]. Chin J Child Heal Care, 2020, 28(1): 28-31. https://www.cnki.com.cn/Article/CJFDTOTAL-ERTO202001011.htm
[12]	刘军, 程欢, 翟立红, 等. 不同皮肤接触时间对剖宫产新生儿早期母乳喂养行为的影响[J]. 护理学杂志, 2023, 38(3): 36-39. https://www.cnki.com.cn/Article/CJFDTOTAL-HLXZ202303009.htm LIU J, CHENG H, ZHAI L H, et al. Effects of different durations of skin-to-skin contact on early breastfeeding behavior of newborns after Cesarean section[J]. Journal of Nursing Science, 2023, 38(3): 36-39. https://www.cnki.com.cn/Article/CJFDTOTAL-HLXZ202303009.htm
[13]	杨婧, 魏娜, 刘晓亚, 等. 延长产后母婴皮肤接触时间对母乳喂养的影响[J]. 中国儿童保健杂志, 2021, 29(5): 565-568. https://www.cnki.com.cn/Article/CJFDTOTAL-ERTO202105026.htm YANG J, WEI N, LIU X Y, et al. Effect of prolonged postpartum maternal and infant skin contact time on breastfeeding[J]. Chin J Child Heal Care, 2021, 29(5): 565-568. https://www.cnki.com.cn/Article/CJFDTOTAL-ERTO202105026.htm
[14]	王丹妮, 韦婷, 罗小婷, 等. 445例早产儿6个月内纯母乳喂养影响因素分析[J]. 中华全科医学, 2021, 19(10): 1685-1688. doi: 10.16766/j.cnki.issn.1674-4152.002142 WANG D N, WEI T, LUO X T, et al. Analysis of influencing factors of exclusive breastfeeding within 6 months in 445 preterm infants[J]. Chinese Journal of General Practice, 2021, 19(10): 1685-1688. doi: 10.16766/j.cnki.issn.1674-4152.002142
[15]	李冬如, 国林青, 农素红, 等. 分娩后即刻给予90 min母婴皮肤接触对妊娠期糖尿病产妇新生儿的影响[J]. 广西医学, 2023, 45(4): 492-497. https://www.cnki.com.cn/Article/CJFDTOTAL-GYYX202304024.htm LI D R, GUO L Q, NONG S H, et al. Effect of skin contact 90 minutes immediately after delivery on neonates of puerpera with gestational diabetes mellitus[J]. Guangxi Medical Journal, 2023, 45(4): 492-497. https://www.cnki.com.cn/Article/CJFDTOTAL-GYYX202304024.htm