Influence And Analysis On The Cognitive Function Of Puerpera In Early Postpartum Period

Objective: To observe the cognitive function of different delivery mode in early periods,and to analyze its influencing factors.Methods:120cases of pregnant women who labored for the first time, recently end thepregnancy, ASA Ⅰ~Ⅱ, To the selected pregnant women, the cognitive function wereevaluated before delivery by MMSE: orientation ability, attention and calculation ability,memory, language ability, recalled force, a total of five aspects, twenty items, total pointsrange0～30points, record five aspects ability points and total points of pregnant women.And record the general situation of pregnant women: age, degree of education, maternaltime, nation, ASA grading and complication of pregnancy. Complications of pregnancyincluding: anemia, hypoproteinemia, heart disease, diabetes mellitus, pregnant associatedthrombocytopenia and intrahepatic cholestasis of pregnancy. Puerpera were divided intocesarean section group(C group, n=60) and natural birth group(N group, n=60) accordingto their mode of delivery. Recorded delivery or operational hemorrhage, newbornsituation (sex,whether or not to neonatal unit after birth). N group record stage of labor, Cgroup record time of operation and analgesic way. The cognitive functions in five aspects,twenty items were tested using the parallel version MMSE by the same testerat1d,3d,5d in postpartum. Compared scores of five aspects of ability, scores ofcognitive function and prenatal changes. If postpartum points dropped2points or morecompared with that in prenatal, the incidence of cognitive dysfunction can be determined.Results:1. The incidence rate of postpartum POCD in two groups:①Postpartum of the1d, N group occurred5cases, the incidence rate of POCD was8.3%; C group occurred8cases, the incidence rate was13.3%; the cognitive dysfunction in group C was slightlyhigher than that of group N, there were no significant difference between two groups. ②Postpartum of the3d, N group occurred2cases, the incidence rate of POCD was3.6%;C group occurred4cases, including2cases of new onset, the rate was6.7%; the cognitivedysfunction in group C was higher than group N, no significant differences between thetwo groups.③Postpartum of the5d, N group occurred1cases, the incidence rate of POCDwas7.8%; C group occurred1cases, the rate was2%, the cognitive dysfunction in group Nwas higher than that of group C, and there were no significant difference between twogroups.④P ostpartum of the1d,3d,5d,15cases(N group5cases; C group10cases)occurred POCD in both groups, the incidence rate of POCD was12.5%(15/120), therewere no significant difference between the two groups.2. Prenatal andpostnatal MMSE scores in two groups:①MMSE scores on postpartum1d in two groupswere declined than antepartum, and the MMSE scores on postpartum3d and5d were risedthan antepartum and postpartum1d.②Compared between groups,there were nosignificant difference between the two groups in MMSE scores on either antepartum orpostpartum1d,3d,5d.③Compared in groups, MMSE scores in both groups were rised onpostpartum3d and5d than antepartum and postpartum1d, there were significant differencebetween the two groups. The MMSE scores in Group C on postpartum5d were increasedcompared with the postpartum3d and the difference was statistically significant.3. Scoresof orientation, memory, attention, calculation, recalled force and language ability inantepartum and postpartum of both groups: postpartum1d, scores of two groups’ memory,attention, calculation ability were down than antepartum, and orientation, recalled forceand language ability scores hold the line or slightly increased than antepartum.②C ompared between groups, two groups of antepartum and postpartum1d,3d,5d abouttheir orientation, memory, attention, calculation, recalled force and language ability scores,differences had no statistical significance.③W ithin the group comparison, in group N onpostpartum of the3d, memory, attention, calculation ability scores increased thanpostpartum1d, the difference was statistically significant; In Group C on postpartum of the3d and5d, attention, computational and memory ability scores increased than postpartumof the1d, the difference was statistically significant; Attention, computational and memoryability scores increased than prenatal on postpartum5d in group C, the difference was statistically significant.4. Stratified analysis of influencing factors showed: Complicationsof pregnancy, transfering department after neonatal birth and the amount of bleeding indelivery and operation were the influencing factors of early postpartum POCD (P <0.05);Effects of age, nation, degree of education, maternal time, ASA grading, sex of newborn,stage of labor, the operation time and manner of analgesia were not statistically significant.Conclusion:①The occurrence of postpartum early cognitive dysfunction is not affectedby the way of delivery, natural birth group and cesarean section group both had theoccurrence of the early postpartum POCD, the incidence rate to the highest onpostpartum of the1d, and declined with the extension of time.②P ostpartumdecliningin cognitive function hass closer relationship with impaired memory, attention andcalculation, and the relationship between orientation, memory, language ability are notvery obvious.③Transfering department after neonatal birth and the amount ofbleeding indelivery and operation were the influencing factors of early postpartum POCD.