Dozier Ann M, Nelson Alice, Brownell Elizabeth
Department of Public Health Sciences, University of Rochester, 265 Crittenden Boulevard., CU 420644, Rochester, NY 14642-0644, USA.
Adv Prev Med. 2012;2012:902487. doi: 10.1155/2012/902487. Epub 2012 Dec 31.
Stressful life events during pregnancy negatively affect maternal and infant outcomes including breastfeeding initiation. Their impact on breastfeeding duration is uncertain. Given breastfeeding's important health benefits we analyzed stressful life event types and cessation of any and exclusive breastfeeding by 4 and 13 weeks. Methods. We collected self-administered survey data at 5-7 months postpartum from over 700 primarily urban low-income US mothers. Data covered prepregnancy, prenatal, and postpartum periods including 14 stressful life events (categorized into financial, emotional, partner-associated, traumatic). Analyses included only mothers initiating breastfeeding (n = 341). Logistic regressions controlled for maternal characteristics including a breastfeeding plan. Results. All four stress categories were associated with shorter duration of any and exclusive breastfeeding. In the adjusted models, statistically significant relationships remained for financial stress (4 weeks cessation of any breastfeeding duration) and traumatic stress (13 weeks exclusive breastfeeding cessation). Controlling for stress, a longer breastfeeding plan was significantly associated with a shorter breastfeeding duration (all models) as was depression during pregnancy and current smoking (several models). Conclusions. Among low-income women, impact of stressful life events on cessation of breastfeeding may differ by stress type and interfere with achievement of breastfeeding goal. Among these stressed mothers, breastfeeding may serve as a coping mechanism.
孕期的生活压力事件会对母婴结局产生负面影响，包括母乳喂养的开始。它们对母乳喂养持续时间的影响尚不确定。鉴于母乳喂养对健康有重要益处，我们分析了压力生活事件的类型以及在4周和13周时任何母乳喂养和纯母乳喂养的停止情况。方法。我们在产后5至7个月收集了700多名主要来自美国城市低收入母亲的自我管理调查数据。数据涵盖孕前、孕期和产后时期，包括14种压力生活事件（分为经济、情感、伴侣相关、创伤性）。分析仅包括开始母乳喂养的母亲（n = 341）。逻辑回归控制了包括母乳喂养计划在内的母亲特征。结果。所有四种压力类别都与任何母乳喂养和纯母乳喂养的持续时间较短有关。在调整后的模型中，经济压力（任何母乳喂养持续时间在4周时停止）和创伤性压力（纯母乳喂养在13周时停止）的统计学显著关系仍然存在。在控制压力的情况下，更长的母乳喂养计划与更短的母乳喂养持续时间显著相关（所有模型），孕期抑郁和当前吸烟也是如此（几个模型）。结论。在低收入女性中，压力生活事件对母乳喂养停止的影响可能因压力类型而异，并干扰母乳喂养目标的实现。在这些有压力的母亲中，母乳喂养可能是一种应对机制。
