Shawky Sherine, Abalkhail Bahaa A
Department of Family and Community Medicine, Faculty of Medicine and Allied Sciences, King Abdulaziz University, Jeddah, Saudi Arabia.
Paediatr Perinat Epidemiol. 2003 Jan;17(1):91-6. doi: 10.1046/j.1365-3016.2003.00468.x.
Recently, there has been increasing concern about the decline in breast-feeding pattern in developing countries. The objectives of this study were to document the recent breast-feeding trends in Jeddah during the first year of an infant's life and identify the probable maternal risk factors implicated in breast-feeding cessation. Data were collected from six randomly selected primary health care centres in Jeddah City. All married women with an infant </= 12 completed months of age were interviewed, and information on socio-demographic characteristics, breast feeding and contraceptive use were collected. Cox proportional hazard regression model was used to calculate the adjusted odds ratios for the various maternal risk factors related to breast-feeding cessation. A total of 400 women were enrolled in the study. Their mean age at delivery was 28.0 years (SD = 4.1 years). Approximately 40.0% had never attended school, 43.0% had at least five children and 13.8% were smokers. Deliveries by caesarean section were reported by 13.0% of women and contraceptive use by 44.7%, among whom oral contraceptives were the commonest method. Around 94.0% of women ever initially breast fed their infants, and this proportion dropped to 40.0% by the infant's 12th month. Women who delivered by caesarean section (OR = 1.9 [95% CI 1.3, 2.8]P = 0.001) and those who used oral contraceptives (OR = 1.5 [95% CI 1.1, 2.2]P = 0.031) were at higher risk of stopping breast feeding and lower probability of maintaining breast feeding to the 12th month post partum than those who delivered vaginally and did not use oral contraceptives. Breast-feeding practice seems to decline rapidly during the first year of the infant's life. Health care professionals should promote breast-feeding practice as early as the antenatal period. They should also take into consideration the impact of caesarean section deliveries and early oral contraceptive use to avoid their negative impact on breast-feeding practice.
最近，发展中国家母乳喂养模式的下降引起了越来越多的关注。本研究的目的是记录吉达市婴儿出生后第一年近期的母乳喂养趋势，并确定与停止母乳喂养相关的可能的母亲风险因素。数据来自吉达市随机选择的六个初级卫生保健中心。对所有婴儿年龄≤12个月的已婚妇女进行了访谈，并收集了社会人口学特征、母乳喂养和避孕使用情况的信息。使用Cox比例风险回归模型计算与停止母乳喂养相关的各种母亲风险因素的调整比值比。共有400名妇女参与了该研究。她们的平均分娩年龄为28.0岁（标准差=4.1岁）。约40.0%的妇女从未上学，43.0%的妇女至少有五个孩子，13.8%的妇女吸烟。13.0%的妇女报告为剖宫产，44.7%的妇女使用避孕措施，其中口服避孕药是最常用的方法。约94.0%的妇女最初曾母乳喂养婴儿，到婴儿12个月时这一比例降至40.0%。与经阴道分娩且未使用口服避孕药的妇女相比，剖宫产的妇女（比值比=1.9[95%可信区间1.3，2.8]P=0.001）和使用口服避孕药的妇女（比值比=1.5[95%可信区间1.1，2.2]P=0.031）停止母乳喂养的风险更高，产后12个月维持母乳喂养的可能性更低。母乳喂养行为在婴儿出生后的第一年似乎迅速下降。医护人员应在孕期尽早促进母乳喂养行为。他们还应考虑剖宫产分娩和早期使用口服避孕药的影响，以避免其对母乳喂养行为产生负面影响。
