二孩政策下经产妇不同胎次母乳喂养及母婴保健服务的定量研究

发布时间：2018-02-24 20:03

本文关键词： 二孩政策经产妇胎次母乳喂养母婴保健　出处：《中国全科医学》2017年29期 　论文类型：期刊论文

【摘要】：目的分析二孩政策开放后,经产妇不同胎次母乳喂养及母婴保健情况,探索改善母乳喂养状况及母婴保健的方法。方法于2017年1—3月,采用多阶段分层抽样方法,将浙江省11个地级市按照经济水平由高到低分为3层,每层随机抽取1个城市,每个城市抽取2个市辖区,每个市辖区抽取1个社区卫生服务中心。选取已在社区卫生服务中心登记、二胎无出生缺陷且年龄为6个月~3周岁,无器质性疾病的健康母亲进行调查。采取自拟问卷方式调查,内容包含调查对象基本信息、主要照顾孩子的亲人、妊娠前评估情况。比较并分析一胎和二胎6个月内喂养方式、(纯)母乳喂养持续时间、终止母乳喂养的原因、是否有过母乳喂养困难及最有效帮助的来源、一胎和二胎孕妇学校参与度及分娩后访视差别。结果经济发展Ⅰ类、Ⅱ类和Ⅲ类地区分别有41名、73名和54名二孩母亲。不同二胎受孕年龄经产妇妊娠前生殖评估行为比较,差异有统计学意义(χ~2=7.816,P0.01)。不同胎次经产妇0~6月龄喂养方式一致性较差(Kappa=0.292,P0.01),喂养方式比较,差异有统计学意义(W=24.997,P=0.035)。二胎纯母乳喂养持续时长、母乳喂养持续时长均长于一胎(P0.05)。不同胎次母乳喂养困难经历情况一致性一般(Kappa=0.499,P0.01),母乳喂养困难经历情况比较,差异有统计学意义(χ~2=4.45,P=0.034)。"有经验的亲人或朋友""自己搜索解决办法"是不同胎次经历母乳喂养困难时最有效帮助的来源。不同胎次孕妇学校参与情况均约占50.0%,一致性一般(Kappa=0.502,P0.01),孕妇学校参与情况比较,差异无统计学意义(W=1.097,P=0.778)。二胎分娩回家后,有81例(48.2%)母亲仍需要母乳喂养知识及技巧的教育指导。不同胎次产后访视情况一致性一般(Kappa=0.431,P0.01),产后访视情况比较,差异有统计学意义(W=18.964,P0.01)。结论二胎时纯母乳喂养率较一胎时提高,二胎(纯)母乳喂养持续时长比一胎时延长。两胎次孕妇学校参与度均不足50.0%。基层妇幼保健机构分娩后访视次数及内容与国家规范尚存差距。全科医生可为需照护孙辈的签约老年居民提供母乳喂养指导,以改善母乳喂养现状。
[Abstract]:Objective to analyze the situation of breast-feeding and maternal and infant health care after the opening of the two-child policy, and to explore the methods to improve the status of breast-feeding and maternal and infant health care. Methods from 2017 to March 1-3, multi-stage stratified sampling was used. The 11 prefecture-level cities in Zhejiang Province were divided into three levels according to their economic level, one city was randomly selected from each level, and two municipal districts were drawn from each city. One community health service center is selected from each municipal district. The second child is registered with the community health service center and the age of the second child is 6 months to 3 years of age. Health mothers without organic diseases were investigated by self-designed questionnaires, which included basic information of the subjects, and mainly cared for the relatives of their children. Pre-pregnancy assessment. Compare and analyse the duration of (exclusive) breastfeeding within six months of one-child and two-child feeding, the reasons for termination of breastfeeding, whether there have been breastfeeding difficulties and the most effective sources of help. Results there were 41 mothers with second child and 54 mothers with second child in the area of economic development. The difference was statistically significant (蠂 ~ (2 / 2) 7.816 / P _ (0.01)). The consistency of 0 ~ 6 months old feeding mode of women with different birth order was worse than that of Kappa (0.292) P _ (0.01). The difference was statistically significant (蠂 ~ (2 / 2) / 7.816 / P ~ (0.035)). The duration of exclusive breast-feeding was long, and the difference was significant (P < 0.05). The duration of breast-feeding was longer than that of one baby (P0.05). The experience of different breast-feeding difficulties was similar to that of Kappa-0.499n P0.01.The experience of breast-feeding difficulties was compared. The difference was statistically significant (蠂 2: 4.45). "experienced relatives or friends" "self-search solution" was the most effective source of help when different births experienced breast-feeding difficulties. The school participation in different gravidas was about 50.0%. Generally speaking, Kappa (0.502) and pregnant women's schools (P0.01a) were compared in terms of the participation of pregnant women's schools. The difference was not statistically significant. After the second child returned home, 81 cases (48.2%) still needed education guidance on knowledge and skills of breastfeeding. The consistency of postpartum visits among different births was generally consistent with that of Kappa 0.431 (P 0.01), and postpartum visits were compared. The difference was statistically significant (P 0.01). Conclusion the exclusive breast-feeding rate in the second child is higher than that in the first child. Second (pure) breast feeding duration is longer than that of one child. The school participation of two pregnant women is less than 50. 0. The number and content of visits to primary maternal and child health care institutions after delivery are different from the state standard. Elderly residents who have signed up to care for their grandchildren provide breastfeeding guidance. To improve breastfeeding status.
【作者单位】：浙江大学医学院;浙江大学医学院社会医学与全科医学研究所;
【分类号】：R173

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