Afifi Mustafa
Department of Primary Health Care, Ministry of Health, Dubai, UAE.
Oman Med J. 2008 Apr;23(2):72-7.
To evaluate the potential for Lactational Amenorrhoea Method (LAM) and passive LAM among women with children below 6 months in the 2003 Egypt Demographic Health Survey (2003 EDHS), to assess the determinants of amenorrhea, and to examine the association of exclusive breastfeeding and amenorrhea with using modern contraceptive methods among nursing mothers of children below 2 years, adjusting for other associated variables.
Data from the 2003 EDHS was downloaded from the DHS website. A sub-sample of women fulfilling all the four criteria were selected: 1) women with last birth of children less than 2 years; 2) currently married; 3) not being sterilized; and 4) currently breast feeding their children. Accordingly, 1934 women entered into the statistical analysis, of them 629 had children below 6 months.
Nearly 24% of nursing mothers with children below 6 months met LAM criteria, of them passive LAM users constituted 79.1%. For women with children below 24 months, determinants of amenorrhea were exclusive breast feeding, unemployment, number of living children, husband education, number of feeding at night, and having a male sex child. Higher education, urban residence, positive attitude towards contraception increased the likelihood of modern contraceptives use, whereas amenorrhea, exclusive breast feeding, and having a wanted child decreased its likelihood in multivariate analysis.
Exclusive breast feeding was associated with amenorrhea and modern contraceptive methods use in a direct and inverse fashion respectively. LAM is a commonly used method but it is liable to discontinuation or violation of its criteria. Hence, it is recommended to educate both the health care providers and users about it.
在2003年埃及人口与健康调查(2003 EDHS)中,评估6个月以下儿童的母亲采用哺乳期闭经法(LAM)和被动LAM的可能性,评估闭经的决定因素,并在调整其他相关变量的情况下,研究2岁以下儿童的哺乳期母亲纯母乳喂养及闭经与使用现代避孕方法之间的关联。
从人口与健康调查(DHS)网站下载2003 EDHS的数据。选择符合所有四项标准的女性子样本:1)最后生育子女的时间少于2年;2)目前已婚;3)未绝育;4)目前正在母乳喂养子女。因此,1934名女性进入统计分析,其中629名有6个月以下的孩子。
近24%有6个月以下孩子的哺乳期母亲符合LAM标准,其中被动LAM使用者占79.1%。对于有24个月以下孩子的女性,闭经的决定因素包括纯母乳喂养、失业、存活子女数量、丈夫教育程度、夜间喂奶次数以及孩子为男性。在多变量分析中,高等教育、城市居住、对避孕持积极态度增加了使用现代避孕方法的可能性,而闭经、纯母乳喂养以及有一个想要的孩子则降低了这种可能性。
纯母乳喂养分别与闭经和使用现代避孕方法呈直接和反向关联。LAM是一种常用方法,但容易中断或违反其标准。因此,建议对医疗保健提供者和使用者进行相关教育。