Breast-feeding among neonatal inpatients in neonatal departments before and after the COVID-19 pandemic in Guangdong province: a multicenter retrospective survey
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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。 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. -
Key words:
- breast-feeding /
- inpatient newborn /
- COVID-19 pandemic /
- neonatal department
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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 n % n % n % n % n % 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。 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 n % n % 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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