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纯母乳喂养、产妇 HIV 病与 HIV 感染哺乳期妇女临床乳房病理学风险

Exclusive breastfeeding, maternal HIV disease, and the risk of clinical breast pathology in HIV-infected, breastfeeding women.

机构信息

Center for Global Health and Development, Boston University School of Public Health, Boston, MA 02118, USA.

出版信息

Am J Obstet Gynecol. 2011 Oct;205(4):344.e1-8. doi: 10.1016/j.ajog.2011.06.021. Epub 2011 Jun 15.

Abstract

OBJECTIVE

The objective of the study was to examine the relationship between breastfeeding patterns, markers of maternal human immunodeficiency virus (HIV) disease, and woman's breast pathology.

STUDY DESIGN

Secondary data analysis from a randomized breastfeeding trial including 947 HIV-infected women (n = 5982 visits) from breastfeeding initiation until 6 months postpartum; 1 month after breastfeeding cessation; or loss to follow-up or death. Generalized estimating equations assessed the effects of breastfeeding pattern and maternal HIV status on breast pathology.

RESULTS

One hundred ninety women (20.1%) had a breast problem; 86 (9.1%) had mastitis; and 31 (3.3%) had abscess. After confounder adjustment, nonexclusively breastfeeding women had an increased risk of breast problems (odds ratio, 1.98; 95% confidence interval, 1.33-2.95) and mastitis (odds ratio, 2.87, 95% confidence interval, 1.69-4.88) compared with exclusive breastfeeders. Women with a CD4 count less than 200 cells/μL tended to have an increased risk of abscess.

CONCLUSION

Nonexclusive breastfeeding significantly increased the risk of breast pathology. Exclusive breastfeeding is not only optimal for infant health but it also benefits mothers by reducing breast problems.

摘要

目的

本研究旨在探讨母乳喂养模式、母婴人类免疫缺陷病毒 (HIV) 疾病标志物与女性乳房病理学之间的关系。

研究设计

对一项母乳喂养随机试验的二次数据分析,纳入了 947 名 HIV 感染妇女(n = 5982 次就诊),随访时间从开始母乳喂养至产后 6 个月;停止母乳喂养后 1 个月;或失访或死亡。广义估计方程评估了母乳喂养模式和母婴 HIV 状况对乳房病理学的影响。

结果

190 名妇女(20.1%)有乳房问题;86 名(9.1%)患有乳腺炎;31 名(3.3%)患有脓肿。在调整混杂因素后,非纯母乳喂养妇女发生乳房问题(优势比,1.98;95%置信区间,1.33-2.95)和乳腺炎(优势比,2.87,95%置信区间,1.69-4.88)的风险高于纯母乳喂养者。CD4 计数<200 个/μL 的妇女脓肿风险增加。

结论

非纯母乳喂养显著增加了乳房病理学的风险。纯母乳喂养不仅对婴儿健康最有利,而且还可以通过减少乳房问题使母亲受益。

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