【摘要】 目的:探讨孕晚期皮肤接触(SSC)模拟训练考核对初产妇母乳喂养的影响。方法:选取2018年1月—2021年9月在深圳市福田区妇幼保健院产科分娩的2 578例初产妇为研究对象，随机分为常规组1 513例和训练考核组1 065例。常规组孕妇正常参加常规产检，接受孕妇学校的母乳喂养理论培训。训练考核组在常规组产检的基础上，孕妇从孕28～40周，在资深助产士专业指导下，模拟母婴孕晚期皮肤接触和母乳喂养实操训练-考核-复训。比较两组产妇的母乳喂养知识掌握情况、母乳喂养自我效能量表(BSES)分值及纯母乳喂养率；两组婴儿的首次母乳喂养情况、体重及身高差异；进一步对两组婴儿出生42 d纯母乳喂养的影响因素进行二元Logistic回归分析。结果:产后2周，训练考核组的母乳喂养知识掌握良好率高于常规组，差异有统计学意义(P<0.05)。产后2周、42 d、3个月，训练考核组产妇的BSES分值及婴儿纯母乳喂养率高于常规组，差异有统计学意义(P<0.05)。出生7 d、15 d和42 d,训练考核组的体重及身高均高于常规组。出生15 d和42 d两组的体重差异有统计学意义(P<0.05);出生7 d、15 d和42 d,两组的身高差异有统计学意义(P<0.05)。二元Logistic回归分析显示，训练考核[OR=6.971,95%CI(1.167,41.647)]是婴儿出生42 d纯母乳喂养的保护因素。结论:孕晚期皮肤接触模拟训练考核提高了初产妇母乳喂养知识掌握率和母乳喂养的自信心，提高了婴儿纯母乳喂养率，改善了婴儿的首次母乳喂养情况，维护了婴儿体重的正常增长。更多还原

【Abstract】 Objective:To explore the effect of simulated training examination of skin to skin contact(SSC) in the third trimester of pregnancy on breastfeeding of primiparas.Methods:From January 2018 to September 2021,2578 pregnant women who gave birth in Shenzhen Futian District Maternity and Child Healthcare Hospital were randomly divided into 1513 cases in the routine group and 1 065 cases in the training and assessment group.The pregnant women in the routine group normally participated in the routine birth examination and received the theoretical training of breastfeeding in the pregnant women′s school.On the basis of routine prenatal examination, the training and assessment group simulated the practical training-assessment-retraining of maternal and infant skin contact and breastfeeding in the third trimester of pregnancy under the professional guidance of senior midwives from 28 to 40 weeks of pregnancy.The mastery of breastfeeding knowledge, the score of BSES and the rate of exclusive breastfeeding were compared between the two groups; The difference of first breast feeding, weight and height between the two groups; Further binary logistic regression analysis was conducted on the influencing factors of exclusive breastfeeding at 42 days after birth.Results:Two weeks after delivery, the good rate of mastering breastfeeding knowledge in the training and assessment group was higher than that in the routine group, and the difference was statistically significant(P<0.05).At 2 weeks, 42 days and 3 months postpartum, the BSES score of pregnant women and the exclusive breastfeeding rate of infants in the training and assessment group were higher than those in the routine group(P<0.05).The weight and length of the training and assessment group at 7,15 and 42 days of birth were higher than those of the routine group.There was significant difference in body weight between the two groups at 15 and 42 days of birth(P<0.05).There was significant difference in body length between the two groups at 7,15 and 42 days of birth(P<0.05).Binary logistic regression analysis showed that training and assessment[OR=6.971,95%CI(1.167,41.647)] was the protective factor of exclusive breastfeeding at 42 days of birth.Conclusions:The assessment of skin contact simulation training in the third trimester of pregnancy improves the mastery rate of maternal breastfeeding knowledge, enhances maternal self-confidence in breastfeeding, improves the rate of exclusive breastfeeding, improves the first breastfeeding of infants, and maintains the normal growth of infant weight.更多还原