【作者】 毛丽梅；

【导师】 孙秀发；

【作者基本信息】 华中科技大学 ， 营养与食品卫生学， 2005， 博士

【摘要】 一、研究目的产妇自胎儿及附属物娩出至生殖器官恢复或接近正常未孕状态的一段时期称为产褥期(puerperium)，一般为42天。这段时间，我国民间俗称“坐月子”。产褥期是妇女一生中非常特殊的阶段，高质量的产褥期保健，合理的营养和膳食对于产妇及婴儿的健康是至关重要的。如何度过产褥期，在不同的国家和地区有很大的不同。如西方国家的妇女不讲究“坐月子”，在食物选择上也无特别之处，而产褥期休养在中国有着浓厚的传统习俗，讲究静养和食补，在饮食行为上也有不少禁忌。这种传统的“坐月子”方式与妇女健康的关系究竟如何是值得探讨的问题。本项目选择在湖北省城乡地区，采用现况调查和干预研究相结合的方法较全面、系统地调查研究目前妇女在产褥期的饮食及其它相关行为习惯、营养素摄入水平、营养健康状况，分析饮食、行为等诸因素与妇女产褥期健康之间的关系，探讨在现代社会中妇女如何更科学地“坐月子”的问题，并探索行之有效的营养健康教育方法，这对于保证妇女儿童健康，提高人口素质有着非常重要的意义。二、研究方法1．湖北省妇女产褥期饮食、行为及患病的现况调查采用分层抽样和整群抽样相结合的方法，抽取湖北省有一定代表性的武汉市江岸区、武汉市郊东西湖区和湖北省麻城农村地区共2100名2岁以内儿童的母亲作为调查对象，采用自行设计的调查表，由经过统一培训的调查员，对研究对象逐一进行入户问卷调查。获有效问卷1975份，其中武汉市637份，武汉市郊628份、麻城市农村地区710份。2．妇女产褥期饮食、行为的营养保健宣教干预研究(1)在武汉市和湖北省麻城农村地区选择在妇幼保健机构建有孕期保健卡的身体健康的孕晚期妇女作为研究对象，将对象随机分为营养保健宣教干预组和对照组。最后完成追踪调查且资料完整的共302人。(2)于产前和产后住院期间在干预组对象中开展多种形式营养保健宣教，对照组不采取干预措施，但仍同干预组一样接受常规保健服务。两组对象均进行由产前到产后42天的追踪随访(于产后7天、14天、28天对两组产妇进行入户调查，产后42天城市对象到妇幼保健院、农村对象由保健医生入户进行体格检查)。膳食调查采用记录法结合询问法进行。于待产时和产后42天采集静脉血进行有关检测。(3)采用产前集中授课、产后个别讲解、发放宣教材料等方法进行营养保健宣教，宣教内容包括平衡膳食概念、产褥期的合理膳食、摄取蔬菜水果的重要性、如何做产后保健操、产褥期应注意的卫生问题等。采用宣教前后问卷测试、干预组和对照组产褥期饮食、行为、营养健康状况比较的方法来评价宣教效果。3．妇女产褥期患病的影响因素分析本部分利用第二部分追踪随访调查获得的数据，采用多元Logistic逐步回归分析方法研究产褥期患病的影响因素。以上调查得到的资料用foxpro(6.0)或excel建立数据库，采用SAS(8.1)软件包进行统计分析。三、研究结果1．湖北省妇女产褥期饮食、行为及患病的现况调查结果(1)湖北省妇女产褥期存在饮食结构不合理，蛋类等动物性食物摄取过多，蔬菜水果类、奶类摄取过少的现象。产褥期从不吃蔬菜、水果、牛奶的分别占18.00％、78.79％、75.66％；妇女“坐月子”期间平均每日卧床时间为17.95±3.75小时，每天或每周做产后保健操的只占3.75％；一些传统行为习惯如产褥期房间不通风、不到室外活动、不洗澡、洗头、刷牙等在部分妇女中存在。产褥期饮食、行为的影响因素有传统休养观念、受教育程度、是否接受营养指导、相关营养保健知识知晓情况、家庭经济收入、分娩方式等，其中来自长辈的传统休养观念是主要的负性影响因素。(2)妇女在产褥期出现的健康问题较多，59.34％的妇女主诉在产褥期有一种以上的病症发生。常出现的疾病或症状依次为腰背痛、乳腺疾病、便秘、痔疮、子宫复旧不良、贫血、口腔疾病等。(3)妇女的产褥期营养保健知识水平普遍偏低，分别只有14.68％、51.98％、8.71％的对象知晓钙、铁、优质蛋白质的良好食物来源，近50％的对象认为产褥期不能吃蔬菜水果。营养保健知识与良好行为间存在相关关系。影响营养保健知识水平的因素有地区、文化程度、知识来源途径等。2．妇女产褥期饮食、行为的营养保健宣教干预研究结果(1)在接受营养保健宣教以前，调查对象营养保健知识的知晓率较低，干预组和对照组间无显著性差异。宣教后，干预组对象的营养保健知识知晓率明显提高，如关于“牛奶是补钙的最佳食品”的知晓率城市和农村对象分别由原来的43.84％和32.10％提高到89.04％和55.56％；“产妇可以吃蔬菜水果”的知晓率分别由原来的69.86％和62.96％提高到94.52％和86.42％，宣教前后比较差异有极显著性(p＜0.01)。(2)城市干预组对象产褥期平均每日蔬菜、水果、大豆类摄入量分别为145.59g、75.71g、38.55g，显著高于对照组(分别为112.97g、44.74g、18.42g)，差异有显著性(P＜0.05或P＜0.01)，牛奶摄入量也高于对照组，但差异无显著性。农村干预组对象平均每日水果摄入量为31.12g，明显高于对照组(15.43g)差异有显著性(P＜0.01)。城市干预组对象产褥期维生素C、维生素E、钙的摄入量明显高于对照组，经检验，差异有显著性(P＜0.05)。与孕期相比，城市干预组和对照组对象均表现出蛋类、禽类等动物性食品增加，而摄入奶类、蔬菜水果明显减少的特点。尽管干预组对象产褥期蔬菜、水果、奶类的摄入量均高于对照组，但仍远远低于推荐的摄取量。因此城市对象产褥期维生素C、钙的平均每日摄取量只有48.33mg和450.51mg，仅占RNI的37.18％和37.54％。农村干预组和对照组对象均表现出孕期动物性食品缺乏，产后大大增加(如禽类由孕期的每日14.41g增加到105.36g，蛋类由54.66g增加到221.37g)，但从第4周起又急剧下降的特点，非常明显地表现出将大量动物性食物集中在月子里消费的习惯。因此其产褥期能量和蛋白质摄入量均超过RNI(达RNI的125.90％和179.53％)。(3)城市干预组对象产褥期做产后体操的发生率，农村干预组对象晒太阳、洗澡、洗头、做产后体操及室外活动的发生率均明显高于对照组，说明宣教干预在产褥期卫生和活动行为的改变上起到了一定的作用。(4)调查对象贫血患病率高，城乡对象孕晚期贫血患病率分别为45.24％和69.87％，产褥期后有所降低，分别为10.38％和57.52％。农村对象孕晚期血清锌水平明显低于城市对象，产褥期后上升，与城市对象无显著性差异。城乡干预组和对照组对象产褥期体重变化、血红蛋白、血清钙、铁、锌、维生素A等微量营养素水平无显著性差异。(5)城市干预组和对照组对象比较，干预组便秘、腿抽筋和关节痛、下腹痛的发生率明显低于对照组，差异有显著性(P＜0.05或P＜0.01)，农村干预组血性恶露时间延长的发生率显著低于对照组(p＜0.05)，其他疾病的的发生两组间没有显著性差异。城市对象产褥期肛肠疾病、腰腿痛、乳腺疾病、血性恶露时间延长等的发生率均明显高于农村对象。3．产褥期患病的影响因素分析结果运用非条件多元logistic逐步回归分析方法分析各种饮食行为及其他相关因素对产褥期患病的影响，结果显示：(1)产褥期多摄入蔬菜能减少便秘、痔疮、肛裂等肛肠疾病的发生：增加牛奶、鱼类摄入减少腰腿痛的发生；蛋白质、铁摄入量大和摄入动物内脏是改善贫血的保护性因素；产褥期能量摄入过高和卧床时间长是超重或肥胖的危险因素；未发现产褥期摄入蔬菜水果能影响乳汁分泌。(2)做产后健身操可减少肛肠疾病、乳腺疾病的发生，利于缩短血性恶露持续时间，促进子宫复旧；常洗下身可减少生殖泌尿系感染发生的危险性；未发现洗澡、洗头等行为会增加感染或腰腿痛等发生的机会。(3)产褥期过多做家务是肛肠疾病发生的危险因素，每日卧床时间过短是生殖泌尿系感染、血性恶露持续时间延长的危险因素，而后者是子宫复旧不良的标志之一。四、研究结论1．妇女在产褥期出现的健康问题较多，值得引起关注湖北省妇女产褥期营养保健知识水平普遍偏低，存在蔬菜、水果、奶类摄取过少，动物性食品摄取过多，“坐月子”期间长时间卧床不活动、不洗澡洗头洗下身等饮食、行为误区，出现的健康问题也较多，值得引起关注。2．产褥期饮食行为的营养保健宣教干预初见成效，新的产褥期休养方式于产妇的健康更为有利本次采用集中授课、个别讲解、发放通俗易懂的宣教材料相结合的宣教方法，推行产褥期注意膳食平衡、多摄取蔬菜水果、适当减少卧床时间、做产后体操、讲究清洁卫生等新的休养理念，使城、乡干预组对象的营养保健知识水平有了非常明显的提高，同时在改变妇女产褥期饮食行为、从而减少产褥期患病上取得一定效果，说明新的产褥期休养方式于产妇的健康更为有利。根据本次干预研究和因素分析的结果，初步提出适合城乡对象不同特点的科学“坐月子”模式如下：1)营养均衡合理，增加蔬菜水果奶类摄入量产褥期应摄入多样化的食物，才能保证各种营养素满足需要，达到营养均衡。本次调查城市对象维生素C、钙的平均每日摄取量只达RNI的1／3左右，且便秘、肛裂、腰腿痛等疾病发病率较高，与其产褥期蔬菜、水果、奶类摄入较少有关，因此，应调整膳食结构，增加蔬菜、水果、奶类摄入；在农村地区经济条件较差、妇女孕前和孕期营养状况普遍偏低，而活动量相对较大的情况下，农村对象在产褥期摄入比城市对象相对较多的动物性食物应该是有必要的。这样除保证必要的能量供给外，还有利于纠正贫血、缺锌等营养缺乏状况。但要纠正将大量动物性食物集中在月子里消费的习惯，要重视孕前、孕期和“坐月子”后的营养，注意不同阶段的营养均衡。2)做产后健身操，促进机体康复卧床时间过长是超重或肥胖的危险因素，做产后健身操可减少肛肠疾病、乳腺疾病的发生，利于缩短血性恶露持续时间，促进子宫复旧。因此，科学的活动和锻炼非常必要。产后应尽早下床活动并在医务人员指导下坚持做产后健身操，以促进体复员，保持健康体型。3)保证充分的休息和睡眠根据多元logistic回归分析结果，产褥期过多做家务是肛肠疾病发生的危险因素，每日卧床时间过短是生殖泌尿系感染、血性恶露持续时间延长的危险因素。说明传统上讲究静养的“坐月子”方式也有一定科学道理。因此应注意产褥期妇女的生理特点，注意劳逸结合，保证一定的卧床休息和睡眠时间，以帮助产妇恢复疲劳、促进组织修复、增强体力；4)注意会阴部清洗，保持清洁卫生由于恶露的产生，阴道分泌物的增多，产褥期极易并发泌尿、生殖系统感染，而常洗下身可大大减小生殖泌尿系感染发生的危险性，因此保持会阴清洁尤为重要。产褥期应每天清洗会阴部，并适当洗头、洗澡，保持清洁舒适。3．将营养宣教纳入产后保健工作中，对于保证母婴健康意义重大目前各医疗保健机构较注意母乳喂养知识的宣传而忽视了其他方面营养保健知识的宣教，产后访视往往过多重视访视率而忽略了访视的内容和质量，因此孕产妇的营养保健知识相当欠缺。本次采用多途径、多层面的营养保健宣教取得良好效果，建议卫生保健部门今后将营养宣教纳入产后保健工作中，推广新的产褥期休养模式，这对于保证母婴健康有着非常重要的意义。五、研究的创新点1．采用现况调查和干预研究相结合的方法，研究湖北省妇女产褥期饮食、行为与健康的关系，这方面的系统研究尚无前例；2．初步提出适合湖北省城乡对象不同特点的科学的“坐月子”模式；3．首次编制出图文并茂、通俗易懂、专门针对产褥期营养保健的宣教材料，并进行宣教干预研究，评价宣教效果，探索行之有效的宣教方法。对于推广新的产褥期休养理念，保证母婴健康有重要意义。更多还原

【Abstract】 PurposeThe postpartum period, or puerperium, starts about an hour after the deliver of the placenta and includes the following six weeks. The postpartum period is a very special phase in the life of a woman, if not treated appropriately can lead to ill-health and even death for one or both of them. A good postpartum care and rational diet during the postpartum period is very important for the health of the women.The diet and behavior in the postpartum period varies greatly in various countries and regions. The patterns of diet and behavior are different between Chinese women and western women. There are many taboos in diet and behavior during postpartum period in china. The traditional practices are beneficial or harmful, if these taboos have relation to health of women in puerperium? These questions have attracted public concern and discussion.The purpose of this study is to investigate the diet behavior and healthy status of women in Hubei province during the puerperium, explore the relationship between diet and behavior practice and the health of women, evaluate the effects of carrying out nutrition and health education during pregnancy and puerperium, and explore the effective nutrition education method. On the basis of the study, put forward a kind of modern and scientific diet behavior pattern being applicable to Chinese women in the puerperium.Methods1 .The survey on present condition of diet, behavior and healthy status of women during the puerperium.2100 women who had at least one child under 2 years of age were selected as the subjects of the study by cluster-stratified sampling in the rural area, suburb and city of Hubei province. The data were collected through questionnaires. The achieved sample size was 1975 (637 in city, 628 in suburb, 710 in rural areas).Questionnaires used in this investigation were designed by our study group. Interviewers all received training ensured that they thoroughly understood each question and were able to administer them uniformly without any hesitation.2. The follow-up survey and the project of nutrition education.A total of 410 pregnant women (in the third trimester) were randomly selected from women who attended a local maternal health clinic in Wuhan City and the rural areas of Macheng as the subject of follow-up study. The subjects were divided into two groups. Nutrition education was given in one group, another group as control group. The achieved sample size was 302.The subjects were visited after 7 day, 14 day, 28 day, 42 day of delivery. The data were collected through questionnaires. Dietary intake was assessed by a 9 days dietary record and cross checked by a 24 h recall.Nutritional health education was carried out during pregnancy and puerperium. The method of nutrition education include:a.taking a series of nutritional knowledge lectures among the subjects. b.compiling, printing and distributing the material of nutrition education, c.consulting and giving advice face to face.3. The analysis on maternal morbidity during the puerperium and its influencing Factors.The multiple logistic stepwise regression analysis was used to analyze the eating behavior and other relative factors influencing on the Puerperal diseases.Data analysis was conducted using SAS 8.1 statistical software package.Results1. The survey on present condition of diet, behavior and healthy status of women during the puerperium.During the postpartum, subjects consumed abundant poultry and eggs, and meats, but vegetables, fruits and milk were not enough. The 75.66% of them never drank milk, 78.79% never ate fruits and 18.00% never ate vegetables. The average time women keeping the bed were 17.95 ± 3.75 hours everyday. Only 3.75% did gymnastics every day or every week. Some of them never opened the windows or went out, never taked a bath, washed hair or brushed teeth during the puerperium. The results of Logistic regression analysis showed that the significant factors which influenced the dietary and behaviors were traditional concept, education background, nutrition education, the levels of health knowledges, family incomes, delivery ways. The traditional belief was major negative factor.There are many health problems during the puerperium. 59.34% of the women reported at least one symptom. The reported postpartum problems included backaches, arthralgia or leg clonus, breast problems, constipation, haemorrhoids, anaemia, oral disease, uterine subinvolution etc.The women lacked the knowledges about postpartum nutrition and health. Only 14.68%, 51.98% or 8.71% of them knew the good food source of calcium, iron or protein. 50% of them thought that fruits and vegetables intakes were not permissible during puerperium. The women who had higher knowledge levels had better dietary or health behavior than the others. The significant factors which influenced the level of nutrition and health knowledges were area, education background, source of the knowledge etc.2.The follow-up survey and the evaluation on the effectiveness of the nutrition and -health educationBefore nutrition and health education, the knowing rate of nutrition and health knowledge of the subjects was low, and there was not significant difference between the intervention group and the control group. After the subjects of the intervention group being educated, their levels of nutrition and health knowledge were increased significantly. For example, the knowing rate about the question that milk is the best food of calcium supplement, increased from 43.84% to 89.04% in urban areas and from 32.10% to 55.56% in rural areas, and the knowing rate about the question that the parturien can eat vegetables and fruits, increased from 69.86% and 62.96% to 94.52% and 86.42%. The knowing rate was great significant difference between before education and after education (p<0.01).In urban areas, the intakes of vegetables, fruits and soybean in intervention group were more than the control group, significantly, fruits intakes of the intervention group were also more than the control group in rural areas, and the difference was significant between them. In urban areas, the intakes of vitamin C, vitamin E and calcium in intervention group were significantly high, compared with the control group, too. In the urban intervention group, the rate of doing postpartum gymnastics was higher than the control group, and the rate of basking, bathing and washing hair, doing postpartum gymnastics and outdoors activity was higher in the intervention group than in the control group in rural areas. These results showed that the nutrition and health education played a role on changing wrong behaviors of puerperium woman.In the third-stage pregnancy, the prevalence of anemia of the subjects was 45.24% and 69.87%, respectively. After postpartum, the prevalence was 10.38% in urban subjects and 57.52% in rural subjects. Serum zinc concentration of the rural subjects was markedly lower than the urban subjects in the third-stage pregnancy, and there was insignificant difference after postpartum. During postpartum, the difference was insignificant between the intervention group subjects and the control group subjects whether in rural areas or in urban areas in weight changing, haemoglobin levels, the serum concentration of calcium, iron, zinc and vitamine A.There are significant difference on the prevalence of constipation, leg clonus and arthralgia, low abdomen pain between intervention group and control group in urban areas (p<0.05 or p<0.01). In rural areas, the prevalence of lochia rubra duration prolonging was significantly lower in the intervention group than in the control group (p<0.05). The incidence of anal intestines diseases, backaches and leg clonus, breast problems, lochia rubra duration prolonging was obviously higher in urban areas than the incidence in rural areas.Compared with pregnancy, Eggs and poultry intakes of urban subjects were about once during postpartum more than pregnancy, and the intakes of milk, vegetables and fruits were reduced obviously. Daily milk intakes decreased from 285.33g to 60.43g, daily vegetables intakes reduced from 423.2g to 129.74g, and daily fruits intakes decreased from 318.89g to 60.66g. Rural subjects were short of animal foods during pregnancy, and these foods were greatly added during postpartum. For example, poultry were daily eaten 14.41g during pregnancy, increased to 105.36g in the postpartum period, eggs 54.66g to 221.37g. From 4 week postpartum, the intakes of meats, poultry, fish and eggs were decreasing gradually, especially obviously in rural areas. For example, poultry intakes in the sixth week were 1/25 of that in the second week. These results showed that great many animal foods used to be consumed during puerperium.In urban areas, mean daily intakes of Vitamine C and calcium were only 48.33mg, 37.18% of RNI, and 450.51mg, 37.54% of RNI, and mean daily intakes of retinol, thiamin, riboflavin and zinc were also under 70% of RNI. All nutrient intakes of rural subjects whether reached to or exceeded RNI, except for calcium, energy, and protein intakes reached to 129.0% and 179.53% of RNI, respectively. 3. The influencing factors on maternal morbidity during the puerperium The result of the logistic regression analysis showed:Taking more vegetables was the protective factors of reducing the incidence of anal intestines diseases such as constipation, haemorrhoids, and anal fissure during the puerperium. The intakes of milk and fish were the benefic factors for protection agains the backache, leg clonus and arthralgia. Intaking more protein, iron and animal splanchna can protect against anemia. Energy intake and lying in bed too long was the risk factors of overweight and obesity. It wasn’t found that intakes of vegetables and fruits affected lactation.In the postpartum period, doing exercise can reduce the incidence of anal intestines diseases and breast problems, was beneficial to shorten the duration of ochia rubra, and accelerate uterine involution. Washing perineum usually can decrease the risk of genital system and urinary system infection. It was not found that these behaviors such as bathing, washing hair would increase the chance of infection or backache and leg pain.During postpartum period, doing housework too more was risk factor of the anal intestines diseases, having less time stay in bed was risk factor of genital and urinary system infection and longer time of bloody discharge, and the latter was the one of the signs of uterine subinvolution.Conclusion1 .There are many health problems during the puerperium of women, and we must pay close attention to itMost of the women in HuBei Province had little knowledge about nutrition and health care. The intakes of fresh vegetables, fruits and milk products were very low. During the puerperium, they had some wrong behaviors such as: they stayed in bed most of the day and had no physical activities, and they never had a bath or washed their hair or perineum. Such behaviors leaded to some health problems. We have to payattention to it.2. The nutrition and health education on puerperium dietary and behavior madeprimary effects, the new pattern of convalesce during the puerperium is better for the health of the womenWe combined some health education methods like taking lectures together, consulting and giving advices face to face, and distributing popular health education materials, and suggested new pattern of convalesce such as, having balanced diet, taking more fresh fruits and vegetables, properly reducing the time keeping in bed, doing postpartum gymnastics and paying attention to personal hygiene during the puerperium, which made the nutritional health knowledge levels of the subjects both in the city and rural areas being improved obviously, and had made some effects on changing the dietary behaviors of women and decreasing prevalence during postpartum. All these show that the new pattern of convalesce during the puerperium is better for the health of the women.According to the results of this intervention study and factor analysis, during puerperium the scientific living pattern that being elementarily drawn adapting to different subjects in the city and rural areas are followed:a.Balanced nutrition and increasing the intakes of vegetables, fruits and milk productsDuring pueperium, partartum should intake all variety of food to meet all nutrients requirement, reaching to balanced nutrition. In this investigation, the average daily intakes of VitC and calcium of the city subjects were only about 1/3 of RNI, and the prevalence of constipation, anal fissure and backaches and leg clonus was higher, which was relation to the low intakes of vegetables, fruits and milk products. So the diet structure should be adjusted, i.e. increasing the intakes of vegetables, fruits and milk productsIn the rural areas where the economy condition was poor, the women’s nutritional condition before pregnancy and during pregnancy was low, and the physical activity was comparatively more. So it is necessary for the rural subjects to take more animal foods than the city subjects during the puerperium. It not only provides sufficient energy supply, but also corrects some nutritional deficiency diseases like anemia and zinc deficiency. But we have to pay attention to the balanced nutrition of different life phase of a woman, including the nutrition before pregnancy, during pregnancy, during the puerperium and after puerperium.b. Doing postpartum gymnastics to promote recoveryLying in bed too long was the risk factor of overweight and obesity, and doing exercise can reduce the incidence of anal intestines diseases and breast problems, was beneficial to shorten the duration of ochia rubra, and accelerated uterine involution. Therefore, scientific activities and exercises are very essential. Partartum should get up as soon as possible after delivery, and insist in doing postpartum gymnastics under the direction of health providers, to promote recovery and keep healthy bodily form.c.Having sufficient sleeping and restThe results of the logistic regression analysis showed that doing excessive housework during the puerperium was the risk factor of the anal intestines diseases, having less time staying in bed was the risk factor of the reproductory system infection and the duration of ochia rubra prolonging. It showed that paying attention to the physiologic characteristics of the women during the puerperium, doing appropriate housework, having sufficient sleeping and rest, having scientific physical activities and exercises were very important.d.Paying attention to wash perineum, and keeping cleanness and health Because of the discharge, the secretion of vagina increase, and genital system and urinary system infection are subsequent very easily, while washing perineum usually can decrease the risk of genital system and urinary system infection. Thus it is very important to keep perineum cleanness. During puerperium, washing perineum every day, and moderately washing hair and taking bathing are very necessary. 3. We should put the nutritional health education to the job of antenatal and postpartum care.At present, all kinds of medical care organizations only put much more emphasis on the health education of breast-feeding, but ignore the education of nutrition and health care. When taking the postpartum visiting, they pay attention to the visiting rate but ignore the content and quality of it. So the pregnant and lying-in women lack the knowledge of nutritional health care. We recommend the health care agency put the nutritional health education to the antenatal and postpartum health care affairs to improve the quality of health care. This is very significant to ensure the health of mothers as well as their infants.Innovation1. We have made a systematical and comprehensive research on the relationship between the dietary behavior and health of the women during the puerperium in HuBei province. There is no former systematical research in this aspect.2. We have discussed the scientific living pattern of the women during the puerperium in HuBei province, which is suitable for their character and living standard.3. We have designed and compiled a propagandistic material pertinent nutrition and health care during the puerperium for the first time and put up nutritional health education, evaluated the effects and explored the effective nutritional education methods.更多还原