اثر تحریک پستان بر طول مراحل زایمانی: یک مرور سیستماتیک و متاآنالیز

نوع مقاله : مروری

نویسندگان

1 استادیار گروه بهداشت باروری، مرکز تعیین کننده‌های اجتماعی مؤثر بر سلامت، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی تبریز، تبریز، ایران.

2 دانشجوی دکتری تخصصی مامایی، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی تبریز، تبریز، ایران.

3 استادیار گروه مامایی، واحد بناب، دانشگاه آزاد اسلامی، بناب، ایران.

چکیده

مقدمه: طولانی شدن مراحل لیبر برای مادر و نوزاد می‌تواند عوارض جدی را داشته باشد. اثرات مثبت و نویدبخش تحریک نیپل بر طول مراحل لیبر در تعدادی از مطالعات انجام یافته، مشاهده شده است. مطالعه حاضر با هدف تعیین اثرات تحریک پستان بر طول مراحل زایمانی (پیامد اولیه) و نمره بیشاپ و روش زایمان (پیامدهای ثانویه) انجام شد.
روش‌کار: در این مطالعه مرور سیستماتیک و متاآنالیز که بر اساس دستورالعمل پریسما انجام گرفت، جستجوی متون منتشر شده فارسی و انگلیسی، بدون محدودیت زمانی تا تیر ماه 1402 در پایگاه­ های اطلاعاتی معتبرScopus ، Web of science،Google Scholar ، PubMed و پایگاه­ فارسی زبان  SIDبا کلمات کلیدی انگلیسیPhysical stimulation and Labor progress، Stimulation، labor stage، Duration of labor، Breast، Nipple و Labor و کلمات کلیدی معادل فارسی: تحریک پستان، تحریک نوک پستان، طول لیبر، مراحل زایمان، مرحله اول لیبر، مرحله دوم لیبر، مرحله سوم، نمره بیشاپ و روش زایمان لیبر انجام گرفت. دو نویسنده به‌طور مستقل، کیفیت مقالات را با استفاده از از ابزار خطر سوگیری کوکران و ابزار ROBINS-I مورد ارزیابی قرار دادند و متاآنالیز در نرم‌افزار RevMan (ورژن 3/5) انجام شد.
یافته ­ها: از 307 مطالعه یافت شده، 10 مطالعه معیارهای ورود به مطالعه را داشتند. طبق نتایج آنالیز ساب گروپ انجام شده بر اساس گروه کنترل، تحریک نوک پستان در مقایسه با عدم مداخله باعث کاهش معنی­دار طول مرحله اول (4 مطالعه، تفاوت میانگین: 66/2- ؛ فاصله اطمینان 95%: 70/1- تا 61/3- ؛ 001/0p<) و مرحله دوم زایمان (3 مطالعه، تفاوت میانگین: 22/8- ؛ فاصله اطمینان 95%: 62/3- تا 83/12- ؛ 001/0p<) شده بود.
نتیجه­ گیری: اگرچه تحریک پستان در مقایسه با عدم مداخله ممکن است بتواند باعث کاهش طول مراحل زایمانی شود، با توجه به محدود بودن مطالعات در این زمینه، برای توصیه به استفاده از آن، نیاز به انجام مطالعات بیشتر با کیفیت بهتر است. 

کلیدواژه‌ها

موضوعات

عنوان مقاله [English]

The effect of breast stimulation on the duration of labor stages: A systematic review and meta-analysismeta-analysis

نویسندگان [English]

  • Mojgan Mirghafourvand 1
  • Mahsa Maghalian 2
  • Robab Hassanzadeh 3
1 Assistant professor, Department of Reproductive Health, Social Determinants of Health Research Center, School of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran.
2 PhD student of Midwifery, School of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran.
3 Assistant professor, Department of Midwifery, Bonab Branch, Islamic Azad University, Bonab. Iran.
چکیده [English]

Introduction: Prolonged labor stages can have serious consequences for both mother and infant. Positive effects and encouraging results of nipple stimulation on the duration of labor have been observed in some studies. This study was performed with aim to determine the effects of breast stimulation on the duration of labor (primary outcome) and Apgar score and method of delivery (secondary outcomes).
Methods: This systematic review and meta-analysis was conducted according to the PRISMA guidelines. A search of published Persian and English texts without time restrictions up to July 2023 was performed in reputable databases including Scopus, Web of Science, Google Scholar, PubMed, and the SID Persian database with English keywords of Stimulation, Physical stimulation, Labor progress, Labor stage, Duration of labor, Breast, Nipple, and Labor, as well as their equivalent Persian keywords. Two authors independently assessed the quality of the articles using the Cochrane Risk of Bias tool and ROBINS-I tool, and the meta-analysis was conducted using RevMan software (version 5.3).
Results: Out of 307 identified studies, 10 articles met the inclusion criteria. According to the subgroup analysis based on the control group, nipple stimulation compared to no intervention significantly reduced the duration of the first stage of labor (4 studies, mean difference: -2.66; 95% confidence interval: -1.70 to -3.61; p<0.001) and the second stage of labor (3 studies, mean difference: -8.22; 95% confidence interval: -3.62 to -12.83; p<0.001).
Conclusion: Although breast stimulation compared to no intervention may reduce the duration of labor, due to the limited studies in this area, further high-quality studies are needed before recommending its use.

کلیدواژه‌ها [English]

  • Breast
  • Childbirth
  • Meta-analysis
  • Nipple

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مجله زنان، مامایی و نازایی ایران
دوره 26، شماره 12
اسفند 1402
صفحه 66-80

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