Construction of warning model of maternal lactation initiation delay based on breast milk biomarkers and its verification

ZHU Xuefang; HE Wenfei; GU Hong

doi:10.7619/jcmp.20230612

Journal of Clinical Medicine in Practice > 2023 > 27(16): 96-100. > DOI: 10.7619/jcmp.20230612

ZHU Xuefang, HE Wenfei, GU Hong. Construction of warning model of maternal lactation initiation delay based on breast milk biomarkers and its verification[J]. Journal of Clinical Medicine in Practice, 2023, 27(16): 96-100. DOI: 10.7619/jcmp.20230612

Citation:

PDF (1110 KB)

Construction of warning model of maternal lactation initiation delay based on breast milk biomarkers and its verification

Department of Obstetrics, Suzhou Science and Technology City Hospital of Jiangsu Province, Suzhou, Jiangsu, 215153

More Information

Received Date: February 28, 2023
Revised Date: July 02, 2023
Available Online: September 05, 2023

Graphical Abstract

Abstract

Abstract

Objective
To construct an early warning model of delayed initiation of maternal lactation based on breast milk biomarkers and to evaluate its effectiveness.
Methods
A total of 486 puerperae were selected as study objects, and were divided into modeling group (340 cases) and verification group (146 cases) according to a ratio of 7∶3, the modeling group was further divided into delayed lactation initiation group (85 cases) and successful lactation initiation group (255 cases) according to whether the lactation initiation was successful. Logistic regression was used to analyze risk factors for delayed initiation of maternal stage Ⅱ lactation. R software was applied to construct a nomogram model for predicting the risk of delayed initiation of maternal stage Ⅱ lactation. The receiver operating characteristic (ROC) curve and calibration curve were used to evaluate the differentiation and consistency of the nomogram models.
Results
The proportions of patients aged 31 to 40 years old, primipara, cesarean section, and the sodium ion concentration and protein level in the delayed lactation initiation group were greatly higher than those in successful lactation initiation group, the lactose and citrate levels were lower than those in the successful lactation initiation group (P < 0.05). The multivariate Logistic analysis showed that sodium ion, lactose and citrate levels were the influencing factors of delayed initiation of stage Ⅱ lactation (P < 0.05). ROC curve showed that the area under the curve (AUC) of the nomogram model for predicting lactation stage Ⅱ initiation delay was 0.998 in both the modeling group and the validation group. Hosmer-Lemeshow goodness of fit test showed that the predicted value of calibration curve of the nomogram model was basically consistent with the actual value (modeling group: χ²=6.062, P=0.511; verification group: χ²=7.288, P=0.506).
Conclusion
The nomogram model based on lactose, sodium ion and citrate of breast milk biomarkers to predict the risk of delayed initiation of puerpera lactation stage Ⅱ has good consistency and discrimination.
- delayed lactation initiation,
- puerpera,
- breast milk,
- lactose,
- citrate,
- sodium ion,
- nomogram model

FullText(HTML)

References (21)

References

[1]	LYONS K E, RYAN C A, DEMPSEY E M, et al. Breast milk, a source of beneficial microbes and associated benefits for infant health[J]. Nutrients, 2020, 12(4): 1039. doi: 10.3390/nu12041039
[2]	中华医学会围产医学分会, 中华医学会妇产科学分会产科学组, 中华护理学会产科护理专业委员会, 等. 中国新生儿早期基本保健技术专家共识(2020)[J]. 中华围产医学杂志, 2020, 23(7): 433-440. doi: 10.3760/cma.j.cn113903-20200416-00354
[3]	黄海丽, 顾晓青, 封红伟. 上海市宝山区产妇泌乳Ⅱ期启动延迟发生现状及影响因素[J]. 华南预防医学, 2021, 47(12): 1493-1496. https://www.cnki.com.cn/Article/CJFDTOTAL-GDWF202112001.htm
[4]	FOK D, ARIS I M, HO J H, et al. Early initiation and regular breast milk expression reduces risk of lactogenesis Ⅱ delay in at-risk Singaporean mothers in a randomised trial[J]. Singapore Med J, 2019, 60(2): 80-88. doi: 10.11622/smedj.2018067
[5]	HOBAN R, MEDINA POELINIZ C, SOMERSET E, et al. Mother's own milk biomarkers predict coming to volume in pump-dependent mothers of preterm infants[J]. J Pediatr, 2021, 228: 44-52.e3. doi: 10.1016/j.jpeds.2020.09.010
[6]	LI J Y, HUANG Y Y, HUANG Y, et al. Development of a breastfeeding duration risk nomogram for use in postpartum Chinese women[J]. Res Nurs Health, 2022, 45(1): 94-107. doi: 10.1002/nur.22203
[7]	罗凤娟, 包能珍, 李双辉. 妊娠期糖尿病产妇泌乳启动延迟发生风险的预测模型构建及验证[J]. 临床与病理杂志, 2020, 40(6): 1394-1400. https://www.cnki.com.cn/Article/CJFDTOTAL-WYSB202006009.htm
[8]	CHEONG J L Y, BURNETT A C, TREYVAUD K, et al. Early environment and long-term outcomes of preterm infants[J]. J Neural Transm, 2020, 127(1): 1-8. doi: 10.1007/s00702-019-02121-w
[9]	宗小颖, 施江平, 任慧明. 剖宫产初产妇母乳喂养率的调查分析及其与产妇心理状态、产后泌乳时间及个性特征的关系[J]. 中国性科学, 2022, 31(5): 117-120. https://www.cnki.com.cn/Article/CJFDTOTAL-XKXZ202205030.htm
[10]	BABIC A, SASAMOTO N, ROSNER B A, et al. Association between breastfeeding and ovarian cancer risk[J]. JAMA Oncol, 2020, 6(6): e200421. doi: 10.1001/jamaoncol.2020.0421
[11]	张青, 李世珍, 刘青锋, 等. 四川省泸州市纯母乳喂养现状及其影响因素分析[J]. 华南预防医学, 2020, 46(5): 494-497. https://www.cnki.com.cn/Article/CJFDTOTAL-GDWF202005010.htm
[12]	马洁, 葛武鹏, 赵丽丽, 等. 分娩及喂养方式对婴幼儿分泌型免疫球蛋白A的影响[J]. 中国乳品工业, 2020, 48(7): 4-8, 12. https://www.cnki.com.cn/Article/CJFDTOTAL-RPGY202007001.htm
[13]	丁佩佩, 赵梅, 张凤英, 等. 产妇妊娠晚期营养素摄入情况及Ⅱ期泌乳启动延迟影响因素分析[J]. 中国全科医学, 2020, 23(5): 534-539. https://www.cnki.com.cn/Article/CJFDTOTAL-QKYX202005028.htm
[14]	胡珊珊, 刘君, 蒋盘华, 等. 产妇泌乳Ⅱ期启动延迟发生率及影响因素的系统评价[J]. 中国全科医学, 2021, 24(24): 3110-3115. https://www.cnki.com.cn/Article/CJFDTOTAL-QKYX202124014.htm
[15]	姚建蓉, 刘秀萍. 泌乳Ⅱ期启动延迟影响因素研究进展[J]. 预防医学情报杂志, 2018, 34(1): 101-105. https://www.cnki.com.cn/Article/CJFDTOTAL-YFYX201801027.htm
[16]	HOBAN R, PATEL A L, MEDINA POELINIZ C, et al. Human milk biomarkers of secretory activation in breast pump-dependent mothers of premature infants[J]. Breastfeed Med, 2018, 13(5): 352-360.
[17]	袁水琴, 王华, 徐鑫芬, 等. 母乳钠离子浓度变化与泌乳启动关系的研究进展[J]. 护理与康复, 2022, 21(4): 89-91. https://www.cnki.com.cn/Article/CJFDTOTAL-HLKF202204030.htm
[18]	AZULAY CHERTOK I R, HAILE Z T, NI S S, et al. Differences in human milk lactose and citrate concentrations based on gestational diabetes status[J]. Breastfeed Med, 2020, 15(12): 798-802.
[19]	庞艳, 林芳初, 李嫒, 等. 母乳生物标志物在泌乳启动测定中的应用进展[J]. 广西医学, 2021, 43(13): 1636-1639. https://www.cnki.com.cn/Article/CJFDTOTAL-GYYX202113023.htm
[20]	SONG Z X, WANG X X, ZHOU Y Z, et al. Development and validation of prognostic nomogram for postpartum hemorrhage after vaginal delivery: a retrospective cohort study in China[J]. Front Med, 2022, 9: 804769.
[21]	CHEN B N, ZHANG L Y, WANG D, et al. Nomogram to predict postpartum hemorrhage in cesarean delivery for women with scarred uterus: a retrospective cohort study in China[J]. J Obstet Gynaecol Res, 2020, 46(9): 1772-1782.

Cited By

Get Citation

PDF

XML

Article views (104) PDF downloads (12)

Turn off MathJax

Article Contents

Abstract

References

Construction of warning model of maternal lactation initiation delay based on breast milk biomarkers and its verification

Abstract

References

Catalog

Export File

Citation

Format

Content