Lee Henry Chong, Gould Jeffrey B
Department of Pediatrics, Division of Neonatology, University of California, San Francisco, San Francisco, CA 94143-0734, USA.
J Pediatr. 2009 Nov;155(5):657-62.e1-2. doi: 10.1016/j.jpeds.2009.04.064. Epub 2009 Jul 22.
To investigate incidence and factors influencing breast milk feeding at discharge for very low birth weight infants (VLBW) in a population-based cohort.
We used data from the California Perinatal Quality Care Collaborative to calculate incidence of breast milk feeding at hospital discharge for 6790 VLBW infants born in 2005-2006. Multivariable logistic regression was used to examine which sociodemographic and medical factors were associated with breast milk feeding. The impact of removing risk adjustment for race was examined.
At initial hospital discharge, 61.1% of VLBW infants were fed breast milk or breast milk supplemented with formula. Breast milk feeding was more common with higher birth weight and gestational age. After risk adjustment, multiple birth was associated with higher breast milk feeding. Factors associated with exclusive formula feeding were Hispanic ethnicity, African American race, and no prenatal care. Hospital risk-adjusted rates of breast milk feeding varied widely (range 19.7% to 100%) and differed when race was removed from adjustment.
A substantial number of VLBW infants were not fed breast milk at discharge. Specific groups may benefit from targeted interventions to promote breast milk feeding. There may be benefit to reporting risk-adjusted rates both including and excluding race in adjustment when considering quality improvement initiatives.
在一项基于人群的队列研究中，调查极低出生体重儿（VLBW）出院时母乳喂养的发生率及影响因素。
我们使用来自加利福尼亚围产期质量护理协作组织的数据，计算2005 - 2006年出生的6790例极低出生体重儿出院时母乳喂养的发生率。采用多变量逻辑回归分析来研究哪些社会人口统计学和医学因素与母乳喂养有关。还研究了去除种族风险调整后的影响。
在初次出院时，61.1%的极低出生体重儿接受母乳喂养或母乳喂养加配方奶补充。出生体重和胎龄越高，母乳喂养越常见。风险调整后，多胎与更高的母乳喂养率相关。与纯配方奶喂养相关的因素包括西班牙裔种族、非裔美国人种族以及未接受产前护理。医院风险调整后的母乳喂养率差异很大（范围为19.7%至100%），去除种族调整后有所不同。
相当数量的极低出生体重儿出院时未接受母乳喂养。特定群体可能从促进母乳喂养的针对性干预措施中受益。在考虑质量改进举措时，报告调整时包括和不包括种族的风险调整率可能会有帮助。
