新冠疫情前后广东省新生儿科住院新生儿母乳喂养实施情况多中心调查

张春一; 周文姬; 龙芳; 邹静静; 王俊平; 陈运彬

doi:10.11847/zgggws1140089

新冠疫情前后广东省新生儿科住院新生儿母乳喂养实施情况多中心调查

doi: 10.11847/zgggws1140089

张春一^{1, 2},
周文姬¹,
龙芳¹,
邹静静¹,
王俊平¹,
陈运彬^1, ,

1.
广东省妇幼保健院新生儿科，广州 511400
2.
广东省新生儿重症医学专业质量控制中心

基金项目: 广东省医学科学技术研究基金（A2018407）

详细信息

作者简介:
张春一（1980 – ），女，山东青岛人，主任医师，硕士，研究方向：早产儿营养管理

通讯作者:
陈运彬，E-mail：yunbin_chen@hotmail.com

中图分类号: R 174.4
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- 文章访问数: 40
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- 被引次数: 0
出版历程
- 接收日期: 2022-08-22
- 网络出版日期: 2023-03-31
- 刊出日期: 2023-04-10

Breast-feeding among neonatal inpatients in neonatal departments before and after the COVID-19 pandemic in Guangdong province: a multicenter retrospective survey

1.
Neonatal Department, Guangdong Provincial Maternal and Child Health Care Hospital, Guangzhou, Guangdong Province 511400, China

摘要

摘要: 目的了解广东省新生儿科住院新生儿母乳喂养现状及新冠病毒感染疫情防控常态化管理后对其影响。方法于2021年1 — 2月采用方便抽样法，对广东省内40家医院新生儿科进行新冠病毒感染疫情前后（2019年10 — 12月VS. 2020年10 — 12月）住院新生儿母乳喂养实施情况问卷调查，采用χ²或χ²_校正检验分析母乳喂养率及促进母乳喂养措施开展情况，比较疫情前后母乳喂养率及促进母乳喂养措施开展率的差异。结果疫情前20家（50.0%）医院住院新生儿母乳喂养率不足50.0%，母乳喂养率 > 70%的仅5家（12.5%）。疫情后母乳喂养率更急剧下降，仅4家（10.0%）医院母乳喂养率 > 30.0%，24家（60.0%）医院母乳喂养率 < 10.0%，疫情前后差异有统计学意义（P < 0.001）。省市级和县区级医院疫情后母乳喂养率均明显下降，疫情前后差异均有统计学意义（均P < 0.05），疫情前后，省市级和县区级医院之间母乳喂养率差异均无统计学意义（均P > 0.05）。促进母乳喂养15项措施的开展率为5.0%～87.5%，其中分娩前开始母乳喂养宣教（22.5%）、母乳口腔护理（17.5%）、接受捐赠母乳并提供给住院新生儿（5.0%）等6条措施的开展率 < 25.0%。疫情后仅8家（20.0%）医院仍鼓励和接收家属送母乳，与疫情前比较差异有统计学意义（P < 0.001）。结论广东省新生儿科住院新生儿母乳喂养率低，受新冠病毒感染疫情影响，母乳喂养率进一步降低。
- 母乳喂养 /
- 住院新生婴儿 /
- 新型冠状病毒疫情 /
- 新生儿科
Abstract: Objective To examine breast-feeding among neonatal inpatients in neonatal departments before and after normalized containment of coronavirus disease – 2019 (COVID-19) pandemic in Guangdong province. Methods With convenient sampling and a self-designed questionnaire, we conducted a retrospective survey on breast-feeding and its associates among neonatal inpatients in neonatal departments of 40 hospitals at provincial or municipal/county or district level before the COVID-19 pandemic (October – December, 2019) and after normalized containment of the pandemic (October – December, 2020) in Guangdong province. Chi-square test and corrected Chi-square test were used in data analysis. Results Before the COVID-19 outbreak, the breast-feeding rate was less than 50% among the neonatal inpatients in 20 neonatal departments and the rate was higher than 70% only in 5 (12.5%) of the 40 departments surveyed. During the period of normalized containment of the pandemic, the breast-feeding rates declined significantly compared to those before the pandemic among the neonatal inpatients in the departments of the hospitals at various administrative levels, with the rates of higher than 30% in only in 10.0% (4) of the 40 departments and lower than 10% in 60% (24) of the 40 departments (all P < 0.001). There were no significant differences in the breast-feeding rate among the neonatal inpatients in the neonatal departments of hospitals at various administrative levels before the pandemic and during the normalized containment of the pandemic (P > 0.05 for all) . The proportions of the implementation of 15 measures for promoting breast-feeding ranged 5.0% – 87.5% among the 40 neonatal departments, with the proportions of less than 25.0% for the implementations of 6 measures including breastfeeding education before delivery (22.5%), breast-feeding-related oral hygiene (17.5%), and collection of breast milk donation (5.0%). During the normalized containment of the pandemic, only 8 (20.0%) of the 40 neonatal departments continued to collect donated breast milk and the decreased donated breast milk was associated with the declined breast-feeding rate among the neonatal inpatients (P < 0.001). Conclusion The breast-feeding rate was low among neonatal inpatients in neonatal departments of hospitals in Guangdong province and the rate decreased significantly during the period of normalized containment of COVID-19 pandemic.
- breast-feeding /
- inpatient newborn /
- COVID-19 pandemic /
- neonatal department

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图 1 广东省40家医院新生儿科促进母乳喂养措施开展情况

注：1.分娩前开始母乳喂养宣教；2.新生儿科住院期间宣教母乳喂养重要性；3.新生儿科住院期间宣教母乳喂养实施技巧及促进方法；4.发放母乳喂养书面宣教资料；5.分娩室内早吸吮早接触；6.设立母乳库；7.发放储存及运送母乳的宣教资料；8.为家属提供送奶/泵奶设备；9.病区设有具隐私功能的哺乳区/泵奶区；10.接受捐赠母乳并提供给住院新生儿；11.科内实施统一的喂养常规；12.早产儿添加母乳强化剂；13.母乳口腔护理（初乳涂口腔）；14.非营养性吸吮；15.开展母乳巴氏消毒。

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表 1 广东省40家医院新生儿科疫情前后住院新生儿母乳喂养率情况

医院级别		< 10%		11%～30%		31%～50%		51%～70%		> 70%		P 值
医院级别		n	%	n	%	n	%	n	%	n	%	P 值
省市级（n = 21）	疫情前	1	4.76	4	19.05	3	14.29	10	47.62	3	14.29	< 0.001 ^a
	疫情后	11	52.38	8	38.10	0	0	0	0	2	9.52
县区级（n = 19）	疫情前	5	26.32	2	10.53	5	26.32	5	26.32	2	10.53	0.018 ^a
	疫情后	13	68.42	4	21.05	1	5.26	1	5.26	0	0
合计(n = 40)	疫情前	6	15.0	6	15.0	8	20.0	15	37.5	5	12.5	0.000 ^a
	疫情后	24	60.0	12	30.0	1	2.5	1	2.5	2	5.0
注：a Fisher精确概率法。

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表 2 疫情前后广东省40家医院新生儿科病房隔离管理制度

制度类目	疫情前		疫情后		χ² 值	P 值
制度类目	n	%	n	%	χ² 值	P 值
鼓励和接收母乳	37	92.5	8	20.0	42.72	0.000
可进入病房内给住院新生儿哺乳	32	40.0	10	25.0	24.26	0.000
可进入病房进行袋鼠式护理	29	72.5	13	32.5	12.83	0.000
开展家庭陪护病房	3	7.5	3	7.5	0.000 ^a	1.000
注：a 连续校正法。

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