The impact of intrapartum analgesia on infant feeding
The impact of intrapartum analgesia on infant feeding
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DOI：
10.1111/j.1471-0528.2005.00548.x
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发表时间：
2005-07-01
影响因子：
5.8
通讯作者：
Friswell, W
中科院分区：
文献类型：
--
作者：
Jordan, S;Emery, S;Friswell, W
目的探讨分娩镇痛对出院时婴儿喂养的影响。设计回顾性队列研究。设置英国地区综合医院产科病房。人群随机抽取2000年分娩健康单胎婴儿的425例健康产妇。我们检索并分析了相应的联合助产/产科case notes.Main结果测量婴儿喂养方法出院hospital.Results妇女[190/424（45%）]完全瓶喂养他们的婴儿出院。没有人在出院后开始母乳喂养。回归分析显示，奶瓶喂养的主要决定因素如下：母亲年龄[比值比（OR）0.90，95%置信区间[CI] 0.85-0.95每年];职业（OR 0.63，95% CI 0.40-0.99，失业、体力劳动、非体力劳动各类别）;产前喂养意向（OR 0.12，每个类别的95%CI 0.080-0.19，奶瓶喂养、未决定、母乳喂养）;剖腹产（OR 0.25，95% CI 0.13-0.47，剖宫产或阴道分娩）;和分娩时芬太尼的剂量（OR 1.004，95% CI 1.000-1.008，90% CI 1.001-1.007，每微克给药，结论芬太尼与人工喂养之间的剂量-反应关系尚未在其他地方报道。当考虑到婴儿喂养的既定决定因素时，分娩时芬太尼可能会阻碍母乳喂养的建立，特别是在较高剂量下。
Objective To investigate the impact of intrapartum analgesia on infant feeding at hospital discharge.Design Retrospective cohort.Setting Maternity unit of a UK district general hospital.Population A random sample of 425 healthy primiparae delivering healthy singleton babies at term in 2000.Methods A random sample of primiparae delivering term neonates was identified from the birth register. We retrieved and analysed the corresponding joint midwifery/obstetric case notes.Main outcome measure Infant feeding method at discharge from hospital.Results Women [190/424 (45%)] were exclusively bottle feeding their babies at discharge from hospital. No one commenced breastfeeding after hospital discharge. Regression analysis revealed that the main determinants of bottle feeding were as follows: maternal age [odds ratio (OR) 0.90, 95% confidence interval [CI] 0.85-0.95 per year]; occupation (OR 0.63, 95% CI 0.40-0.99 for each category, unemployed, manual, non-manual); antenatal feeding intentions (OR 0.12, 95% CI 0.080-0.19 for each category, bottle feeding, undecided, breastfeeding); caesarean section (OR 0.25, 95% CI 0.13-0.47, caesarean or vaginal delivery); and dose of fentanyl administered intrapartum (OR 1.004, 95% CI 1.000-1.008, 90% CI 1.001-1.007 for each microgram administered, range 8-500 mu g).Conclusions A dose-response relationship between fentanyl and artificial feeding has not been reported elsewhere. When well-established determinants of infant feeding are accounted for, intrapartum fentanyl may impede establishment of breastfeeding, particularly at higher doses.