مشکلات تجربه شده مادران طی سال اول بعد از زایمان و ارتباط آن با نوع زایمان در شهرستان مهاباد سال 1389

نوع مقاله : اصیل پژوهشی

نویسندگان

1 کارشناس ارشد مامایی، گروه مامایی، دانشگاه آزاد اسلامی واحد مهاباد، مهاباد، ایران.

2 استادیار گروه مامایی، مرکز تحقیقات عوامل اجتماعی مؤثر بر سلامت، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی تبریز، تبریز، ایران.

چکیده

مقدمه: تولد نوزاد در بسیاری از زنان، باعث شروع تغییرات طولانی مدت در زندگی، روابط، کار، فعالیت‌های اجتماعی و مسئولیت‌های خانگی آنان می‌شود. این تغییرات نه تنها عملکرد جسمی و روانی، حتی ممکن است عملکرد بیولوژیک زنان را نیز تحت تأثیر قرار دهد. با توجه به وجود مطالعات محدود در زمینه مشکلات سلامتی مادری بعد از زایمان در ایران و حتی در کل دنیا، مطالعه حاضر با هدف تعیین مشکلات تجربه شده توسط زنان طی سال اول بعد از زایمان و ارتباط آن با نوع زایمان انجام شد.
روش کار: این مطالعه توصیفی در سال 1389 بر روی 311 زنی که جهت دریافت مراقبت‌های معمول هفته 36 تا 38 بارداری خود به 6 مرکز (کلیه مراکز) بهداشتی درمانی شهر مهاباد مراجعه کرده و تمایل به شرکت در مطالعه را داشتند، انجام شد. 3 نفر از افراد از مطالعه خارج شدند و پرسشنامه اولیه برای 308 زن باردار تکمیل شد. سپس با زنان در روز هفتم، هفته هشتم و ماه دوازدهم بعد از زایمان در زمینه مشکلاتی که در طی هفته اخیر تجربه کرده بودند، مصاحبه انجام شد. داده‌ها پس از گردآوری با استفاده از نرم افزار آماری SPSS (نسخه 18) مورد تجزیه و تحلیل قرار گرفت. جهت تعیین تفاوت فراوانی مشکلات در هفته اول، هفته هشتم و ماه دوازدهم از آزمون مک نمار و بین زنان با زایمان واژینال و سزارین از آزمون مجذور کای استفاده شد. میزان p کمتر از 05/0 معنی دار در نظر گرفته شد.
یافته ها: بر اساس گزارش خود زنان، در هفته اول بعد از زایمان، 289 نفر (6/91%)، هفته هشتم 277 نفر (3/90%) و در ماه دوازدهم 254 نفر (5/82%) از زنان حداقل یک مشکل را در طی 7 روز گذشته تجربه کرده بودند. مشکلات ذکر شده توسط بیش از یک سوم زنان در هفته اول و هشتم بعد از زایمان، کمردرد (به ترتیب 64% و 60%)، خستگی (به ترتیب 63% و 60%)، سردرد (به ترتیب 47% و 34%) و مشکلات خواب (به ترتیب 32% و 46%) و در ماه دوازدهم خستگی (43%)، مشکلات خواب (36%) و کمردرد (35%) بود. فراوانی مشکلات کمردرد، بی اختیاری ادراری، عفونت دستگاه ادراری و غم و اندوه طی هفته اول بعد از زایمان در افراد با زایمان واژینال نسبت به زنان با زایمان سزارین به طور معنی‌داری بیشتر گزارش شد. در حالی که مشکلات خواب در هر سه مقطع زمانی، یبوست، خستگی، عوارض ناشی از بی‌حسی یا بیهوشی هم در هفته هشتم و هم در ماه دوازدهم و مشکلات شیردهی در ماه دوازدهم در افراد با زایمان سزارین به طور معنی داری بیشتر گزارش شد (05/0>p).
نتیجه گیری: فراوانی مشکلات سلامتی در دوره بعد از زایمان بالا می‌باشد. بنابراین توجه بیشتر به مشکلات مادران در طی دوران بعد از زایمان ضروری می‌باشد. همچنین نتایج این مطالعه می‌تواند دلیل دیگری بر فواید مادری زایمان واژینال باشد.

کلیدواژه‌ها

عنوان مقاله [English]

Mothers’ Problems Experienced During the First Year of Postpartum and Their Association with the Kind of Childbirth in Mahabad, Iran, 2011

نویسندگان [English]

  • Maryam Roohi 1
  • Sakineh Mohammad Alizadeh Charandabi 2
1 M.Sc. of Midwifery, Department of Midwifery, Islamic Azad University of Mahabad, Mahabad, Iran.
2 Assistant Professor, Department of Midwifery, Social Determinants of Health Research Center, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran.
چکیده [English]

Introduction: Childbirth causes many long lasting changes in women’s life, relations, work, social activities, and household responsibilities. These changes not only affect their mental and physical performance, but also their biological functions. Due to limited studies on postpartum maternal health problems in Iran and even in the whole world, the present study was held to determine the problems experienced by women during the first year after childbirth and its association with the kind of delivery.
Methods: This descriptive study was carried out on 311 women who attended at Mahabad public health centers for prenatal care for 36 to 38 weeks of their pregnancy in Mahabad in year 2011. Three of the subjects were excluded from research and the initial questionnaire was completed by 308 women. They were interviewed at 7th day, 8th week, and 12th month postpartum about problems experienced during the past week. Collected data were analyzed by using SPSS statistical software version 18. Fisher test and ratio risk (95%CI) were used in order to determine the difference between women with vaginal delivery and cesarean. P value less than 0.05 was considered statistically significant.
Results: During the 7 days after delivery, 91.6% (n=289) in the first week, 90.3% (n=277) at 8th week and 82.5% (n=245) at 12th month experienced at least one problem. Problem reported by more than one third of the mothers during the first and eighth week were: backache (64% and 60%, respectively), tiredness (63%, 60%), headache (47%, 34%) and sleep disorders (32%, 46%), and during last week of the twelfth month were: tiredness (43%), sleep disorders (36%) and backache (35%). Frequency of problems such as backache, urinary incontinence, urinary tract infection and sorrow during the first week postpartum were more commonly reported by the women with normal vaginal delivery than women with cesarean section. while sleep disorders at all three stages; constipation, fatigue, complications of anesthesia or anesthesia at both the eighth week and twelfth month; breastfeeding problems at the twelfth month were more common among women with cesarean section (p<0.05).
Conclusion: Frequency of health problems increases in the postpartum period. Therefore, it is essential to pay more attention to mothers’ problems during this period.

کلیدواژه‌ها [English]

  • Birth kind
  • Maternal health
  • Postpartum morbidity

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مجله زنان، مامایی و نازایی ایران
دوره 15، شماره 23 - شماره پیاپی 23
هفته اول آبان ماه 1391
آبان 1391
صفحه 28-37

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