Pafupi theka la amayi onse omwe sali kuyembekezera mwadzidzidzi amapezeka mwa amayi omwe amafotokoza ntchito zogwiritsira ntchito njira za kulera mwezi womwe amatha kutenga. Kafukufuku wasonyeza mgwirizano pakati pa mapiritsi oletsa kubadwa ndi kulemera - kuti kulemera kwake kwa amayi kungathandize kuchepetsa kulera kwa m'kamwa. Mimba yosakonzekera ndi kunenepa kwambiri zimaimira matenda opatsirana ku United States. Azimayi ayenera kumvetsetsa kuti kunenepa ndi kulemera kungachepetse kupiritsira kwa mapiritsi.
Ngakhale kuti mapiritsi atha kukhala njira imodzi yotchuka kwambiri popewera mimba, mphamvu zawo zingawonongeke ndi amayi olemera kwambiri.
Chikhalidwe Chamakono
Kuchulukitsa kwawonjezeka kwa zaka 25 zapitazi. Ndipotu, malinga ndi National Center for Health Statistics, kunenepa kwambiri kumapitirirabe kukhala ndi thanzi labwino ku United States ndi padziko lonse lapansi. Mu 2005 mpaka 2006, anthu oposa theka la akuluakulu a US (anthu opitirira 72 miliyoni) adasankhidwa kukhala ochepa. Kafukufukuyu adawonetsanso kuti 35.3% azimayi amavutika ndi kunenepa kwambiri. Poganiza chimodzimodzi, pafupifupi 34 peresenti ya anthu akuluakulu a ku US (27,4% ya akazi) angatengedwe kuti ndi olemera kwambiri. Kulemera kwa thupi kumatanthauzidwa ngati thupi la misala (BMI) la anthu 30 kapena kuposa pamene munthu woposa kunenepa ali ndi BMI ya 25 mpaka 29.9. BMI imawerengedwa kuchokera kulemera kwake kwa munthu ndi kutalika kwake ndipo imapereka chizindikiro choyenera cha mafuta a thupi ndi zolemera zomwe zingayambitse matenda.
Chiyambi
Pambuyo pa Holt et al. kuphunzira, ankakhulupilira kuti kulemera kwa thupi sikungakhudze kupiritsa mapiritsi otha kubereka. Izi zinkakhala zochokera ku gulu la Oxford Family Planning Association lomwe linasindikizidwa mu 2001. Ofufuzawa sanapeze mgwirizano pakati pa kulemera kwa thupi ndi kulephera kwa kulera kwabwino (pambuyo pokonzanso zaka ndi umoyo).
Komabe, amayi makumi asanu ndi awiri (75%) mwa phunziro ili anali kugwiritsa ntchito mapiritsi oletsa kubereka omwe ali oposa 50 kapena ochuluka kwa 50 mcg ya estrogen. Zotsatira za phunziroli sizingagwiritsidwe ntchito kumagwiritsidwe ntchito masiku ano a chithandizo cham'mawa chifukwa (kupatulapo mankhwala ochepa a mapiritsi), mapiritsi ambiri ophatikizira amakhala ndi 30 mpaka 35 mcg ya estrogen, mcg) mitundu imapezeka.
Kafukufuku Watsopano
Holt et al. Anayambitsa maphunziro akuluakulu kwambiri mpaka pano, pofufuza kugwirizana pakati pa kulemera ndi kulumala kwachinsinsi. Anaganiza kuti amayi omwe amagwiritsira ntchito mapiritsi oletsa kubereka (poyerekeza ndi amayi a kulemera kwake), iwo omwe ali olemera kwambiri amakhala ndi mwayi woposa 60 peresenti kuti atenge mimba pamene omwe ali ochepa kwambiri ali ndi mwayi woposa 70% wokhala ndi vuto la kulera. Mwachindunji, kugwirizana pakati pa mapaundi owonjezera ndi mapiritsi kulephera kunayamba pakati pa akazi olemera kwambiri omwe BMI inali ndi 27.3 kapena kupitirira (izi zikanakhala zofanana ndi mkazi wa mamita asanu, 4 inchi amene akulemera mapaundi 160 kapena kuposa). Choncho, amayi omwe amagwiritsira ntchito njira zothandizira kulera ndi omwe BMI anali wamkulu kuposa 27.3 anali ndi chiopsezo chokhala ndi pakati poposa 1.58 poyerekeza ndi ogwiritsira ntchito omwe BMI inali osakwana 27.3.
Komanso, amayi olemera kwambiri amakhala ndi vuto lolephera kubereka ngati akusowa mapiritsi ake a tsiku ndi tsiku. Ndikofunika kuzindikira, komabe zinthu zomwe zikuphatikizapo kutalika, kulemera, kutsatira ndondomeko yowonetsera kubadwa, komanso kugonana kwapakati pazinthu zokhudzana ndi kugonana kunali kudzidzimva mu phunziro ili. Izi zikutanthauza kuti zotsatira zosadziwika zingatheke chifukwa cha malipoti olakwika.
Kafukufuku wa kafukufuku wa 2007 wa Brunner, Huber, ndi Toth akuwulula mgwirizano wofooka, ngakhale wosasinthasintha, pakati pa kunenepa kwambiri ndi kulephera kwa mapiritsi. Zotsatirazo zinawonetsa kuti akazi olemera kwambiri (BMI ≥ 30) anali ndi chiopsezo chachikulu chokhala ndi mimba.
Komabe, atachita kafukufukuwa, adakali ndi mtundu wawo, mtundu wawo, mtundu wawo, ndi amayi awo, adatsimikiza kuti panalibe kugwirizana pakati pa kulemera ndi kubereka kwa m'thupi. Ofufuzawa adalangiza kuti kuphunzira kwawo kungakhale ndi zotsatira zolakwika chifukwa mmalo moyeza ndi kufufuza kafukufukuwo, zotsatira zake zinachokera pa kudzidzimva kwa amayi awo za kutalika kwake ndi kulemera kwake. Chifukwa chakuti akazi amatha kufotokozera kutalika kwawo ndi pansi poti amalemera kulemera kwa mapaundi angapo, BMI ikhoza kukhala yosalondola. Pomalizira, ochita kafukufukuwa sankadziwa zambiri zokhudza kugonana kwapakati kapena ngati amayi sanagwiritse ntchito mapiritsi awo nthawi zonse; Kusaphatikizidwa kwa zinthu izi kungadabwe kwambiri ndi zotsatira za phunziro lino, ndipo ochita kafukufukuwo anafika poti maphunziro akuluakulu, owonjezera ndi ofunikira kuti athe kupeza yankho lomveka bwino loti ngati kunenepa kwambiri kumawathandiza kukhala ndi chithandizo chamalomo.
Chifukwa chake mapiritsi alibe phindu
Mwamwayi, chifukwa chenichenicho chomwe chiwerengero cha amayi olemera kwambiri / kapena owonjezera kwambiri ali pa chiopsezo chachikulu cholephera kugwiritsira ntchito njira zothandizira kulera sikudziwika kwathunthu. Komabe, ziganizo zingapo zomwe zimagwiritsidwa ntchito zowonjezera zikutanthauza zinthu zomwe zimayambitsa chiopsezo chachikulu:
- Mipiritsi ya Hormone: Mapiritsi oletsa kubala masiku ano amakhala ndi mahomoni otsika kwambiri (poyerekeza ndi omwe adayikidwa zaka makumi anayi zapitazo). Opanga mankhwala opatsirana mwachangu amachepetsa miyeso ya mahomoni pofuna kuchepetsa zotsatira zosafuna, monga chiopsezo cha magazi, kupweteka kwa thupi, ndi kupweteka mutu. Pofuna kukhala oyenerera, mapiritsi a piritsi ayenera kuzungulira kudzera m'magazi a mkazi. Ngati mayi ali ndi thupi lalikulu, zingakhale zovuta kuti ma circulation azichitika, makamaka kupatsidwa mahomoni otsika omwe amapezeka mambiri mwa mapiritsi a lero.
- Metabolism: Kawirikawiri, amayi olemetsa amakhala ndi mphamvu yowonjezera, choncho mahomoni a mapiritsi akhoza kufulumira kwambiri. Choncho, pamene mayi amayeza, amamaliza mlingo wake wamadzimadzi; izi zikhoza kuchepetsa nthawi yomwe mapiritsi akugwira bwino.
- Mavitamini a Chiwindi: Azimayi olemera kwambiri amatha kukhala ndi chidziwitso cha chiwindi cha chiwindi; Mitundu yapamwambayi ya mavitamini ingathandize kuthetsa mahomoni m'makululu am'kamwa. Azimayi owopsa amatha kukhala ndi magazi ochuluka kwambiri. Popeza kuti pali minofu yambiri yomwe magazi amafunika kufalitsa ndipo mwinamwake mavitamini amatha kupasula mahomoni mofulumira, magulu ozungulira ma hormoni akhoza kuchepa.
- Kusungirako Hormone: Mahomoni, estrogen ndi progestin , omwe amapezeka m'mapiritsi oletsa kubereka amasungidwa m'mafuta a thupi. Momwemo, maselo ambiri omwe mayi ali nawo, amachititsa kuti mavitamini a piritsi asatengeke m'malo mwa mafuta m'malo moyenda m'magazi ake.
Kodi Zonsezi Zimatanthauza Chiyani?
Kodi tiyenera kutanthauzira kafukufuku kuti atanthauze kuti amayi olemera ayenera kupewa kugwiritsa ntchito mapiritsi oletsa kubereka? Izi sizingakhaledi yankho. Ndipotu, kugwiritsa ntchito njira zothandizira pakamwa kapena pakamwa (ngakhale amayi olemera kwambiri) zikanakhalabe zapamwamba kwambiri. Mwa amayi 100 omwe amatenga njira zothandizira pakamwa kwa chaka chimodzi, phunziro la Holt et al (2005) limasonyeza kuti amayi ena awiri kapena anayi adzatenga mimba chifukwa cholemera kwambiri kapena owonjezera. Komabe, chiopsezo chotere chokhala ndi mimba chikhonza kufanana ndi vuto lalikulu la mimba, zomwe zingaphatikizepo kugonana ndi matenda a shuga, kuthamanga kwa magazi , komanso kubereka kwa masiye.
Kumene Kumayambira
Amayi ambiri othandizira zaumoyo akusankha kuchepetsa kuchepa kwa mapiritsi pogwiritsa ntchito mapiritsi oletsa kubereka ochepa kwambiri komanso ochepa kwambiri kuposa mankhwala ochepa omwe amathandiza kuti atsimikizidwe kuti pali mahomoni okwanira omwe amachititsa kuti ovulation ayambe.
Ngati mukupeza nokha, ndikofunikira kukambirana zonse zomwe mungasankhe ndi zoopsa zanu ndi dokotala wanu. Popeza amayi olemera kwambiri amakhala odwala matenda opatsirana mtima kuposa amayi omwe ali olemera kwambiri, mlingo wapamwamba wa kulera kwachinsinsi ukhoza kuonjezera mavuto ena a mtima. Mwachitsanzo, kafukufuku wasonyeza kuti pangakhale chiopsezo chowonjezereka cha thromboembolism (magazi oundana) pakati pa amayi ovuta kwambiri omwe amagwiritsa ntchito mapiritsi oletsa kubereka. Choncho, dokotala angafunike kusunga mkazi wolemera kwambiri pa mapiritsi oletsa kubereka ndi malangizo kuti agwiritse ntchito njira yowathandiza kubereka kuti athandize kuteteza mimba. Pankhaniyi, njira zothetsera makondomu amuna kapena akazi , sponge , kapena spermicide zingagwiritsidwe ntchito palimodzi ndi mapiritsi. Pomaliza, ngati mayi wolemera kwambiri asankha kuti asakhalenso ndi ana, chizolowezi choletsa kubereka monga chithandizo cha tubal ligation kapena seeroscopic (non-surgical), monga Chofunikira .
Mfundo Yofunika Kwambiri
Popeza pali kugwirizana pang'ono pakati pa mapiritsi apamwamba ndi mapiritsi othandizira , ndikofunika kukambirana izi ndi wothandizira zaumoyo wanu. Komanso, kuyambira poyambirira kupatsidwa mapiritsi, ngati muwona kuti kulemera kwanu kwatha (mwinamwake, mwina madiresi awiri), onetsetsani kuti mumudziwitse wothandizira zaumoyo wanu kuti atsimikizire kuti njirayi ndiyothandiza kwambiri komanso yotetezeka kwambiri Njira yopangira chithandizo kwa inu.
> Zotsatira:
> Brunner Huber, LR & Toth, JL (2007). Kunenepa Kwambiri ndi Kulephera Kudzala Mtengo: Kupeza Kuchokera mu 2002 Kafukufuku Wadziko lonse wa Kukula kwa Banja. American Journal of Epidemiology, 166 (11), 1306-1311.
> Holt et al. (2005). Thupi la Misa ya Thupi, Kulemera, ndi Kulephera Kuthana ndi Mimba. Odwala Matenda ndi Matenda a Gynecology, 105 (1), 46-52.
> Ogden, CL, Carroll, MD, McDowell, MA, & Flegal, KM (2007). Kunenepa Kwambiri pakati pa Akuluakulu a ku United States - Palibe Kusintha Kwambiri Kwambiri Kuyambira 2003 mpaka 2004 .
> Vessey, M (2001). Zolephera zapakhomo zapakati ndi Kulemera kwa Thupi: Zofufuza mu Phunziro lalikulu la Ophunzira. Journal of Planning and Health Care, 27 (2), 90-91.