LACTATION FUNCTION IN WOMEN AFTER DELIVERY OF A MACROSOMIC FOETUS

Abstract

Macrosomia is associated with perinatal and neonatal complications and is considered a significant problem in modern obstetrics. The postpartum period, especially in women who have given birth, is characterised by physiological hypoestrogenism due to lactation. Despite the clear clinical significance of these changes, there is a lack of research in the literature on the combined effect of lactation and macrosomia on the mother and foetus. This makes it difficult to formulate reliable clinical recommendations for the management and rehabilitation of women in the postpartum period. Research objective: to study the characteristics of the formation and preservation of lactation function in women after giving birth to a macrosomic foetus. Research material: The study was conducted on 60 women who gave birth at term: the main group consisted of 30 women who gave birth to macrosomic newborns (body weight ≥ 4000 g); control group — 30 women who gave birth to children of normal weight (3000–3700 g). Research results: We observed 60 women, who were divided into two groups in accordance with the objectives of the study. Before the start of the study, all patients gave their informed voluntary consent to participate in the examination. The patients' ages ranged from 19 to 37 years, with an average age of 26.5±4.1 years in the main group and 25.6±4.2 years in the control group. In 20 (66,67%) women, delivery occurred through the natural birth canal, and in 10 (33,33%) cases, a caesarean section was performed. In newborns born large for gestational age through natural birth, a significant difference (p ≤0.05) in the duration of the second stage of labour was noted, while in abdominal delivery, a significant (p ≤0.05) increase in the duration of surgery and blood loss was noted. Prolactin levels decrease with increasing duration of lactation, while oestradiol levels increase. This may be due to the restoration of the menstrual cycle and hormonal balance after the end of lactation. Conclusion. The main risk factors for foetal macrosomia were: metabolic (obesity and excessive weight gain during pregnancy), physical inactivity, maternal age >35 years, parity of pregnancy and childbirth, genetic and family predictors (genetic predisposition, macrosomia in previous children), and foetal factors (male sex). Lactation, as an important physiological process, plays a key role in providing newborns with all the necessary nutrients and antibodies, which in turn contributes to their healthy growth and development. An individual approach is needed to monitor women after giving birth to a large baby, with the involvement of an obstetric.ian-gynaecologist and a breastfeeding consultant.