Maternal perception of the onset of lactation is a valid, public health indicator of lactogenesis stage II
Maternal perception of the onset of lactation is a valid, public health indicator of lactogenesis stage II
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DOI：
10.1093/jn/130.12.2972
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发表时间：
2000-12-01
影响因子：
4.2
通讯作者：
Pérez-Escamilla, R
中科院分区：
文献类型：
--
作者：
Chapman, DJ;Pérez-Escamilla, R
测试称重是记录催乳II期的“黄金标准”。然而，这种方法在人口研究中是不切实际的。母亲的看法的时间开始泌乳可能是一个有用的代理乳生成阶段II。本研究旨在验证产妇的看法开始泌乳的标志物的乳生成阶段II。妇女（n = 60）剖宫产后招募。从产后24小时（pp）开始，每天3次通过测试称重和母亲感知评估泌乳的开始。泌乳延迟开始定义如下：1）产后60 h时乳汁转移< 9.2 g/次，2）产后72 h时母体感知。进行了错误分类分析。采用多变量logistic回归、双变量分析和考克斯生存分析，评估两种定义下延迟泌乳的决定因素和后果。母亲延迟感知作为催乳延迟指标的敏感性和特异性分别为71.4%和79.3%。四个低转乳率的危险因素是延迟感觉泌乳开始的显著（P < 0.05）或接近显著（P <0.08）预测因素。低牛奶转移和延迟母亲的感知母乳喂养持续时间的影响同样修改了预期的母乳喂养持续时间。牛奶转移和感知变量的P系数的大小和方向是一致的。根据这些结果，我们得出结论，母亲的看法开始泌乳是一个有效的公共卫生指标的乳生成阶段II。
Test weighing is the "gold standard" for documenting lactogenesis stage II. However, this method is impractical for use in population studies. Maternal perception of the timing of the onset of lactation may be a useful proxy for lactogenesis stage II. This study seeks to validate maternal perception of the onset of lactation as a marker of lactogenesis stage II. Women (n = 60) were recruited after cesarean delivery. Beginning at 24 h postpartum (pp), the onset of lactation was assessed 3 times daily by both test weighing and maternal perception. Delayed onset of lactation was defined as follows: 1) milk transfer < 9.2 g/feeding at 60 h pp and 2) maternal perception 72 h pp. Misclassification analyses were conducted. Multivariate logistic regression, bivariate analyses and Cox survival analyses were used to evaluate the determinants and consequences of delayed onset of lactation, using both definitions. The sensitivity and specificity of delayed maternal perception as an indicator of delayed lactogenesis were 71.4 and 79.3%, respectively. Four risk factors for low milk transfer were significant (P < 0.05) or nearly significant (P 0.08) predictors of delayed perception of the onset of lactation. The effects of low milk transfer and delayed maternal perception on breast-feeding duration were similarly modified by intended breast-feeding duration. The magnitude and directionality of the P coefficients for the milk transfer and perception variables were consistent. On the basis of these results, we conclude that maternal perception of the onset of lactation is a valid public health indicator of lactogenesis stage II.