Obstetrics and Maternal Newborn Investigations (OMNI) Research Group, Ottawa Hospital Research Institute, The Ottawa Hospital, Ottawa, ON, Canada.
Diabet Med. 2013 Sep;30(9):1094-101. doi: 10.1111/dme.12238. Epub 2013 Jun 21.
To explore intention to breastfeed and breastfeeding rates in hospital and on discharge across women with pre-gestational or gestational diabetes mellitus, or no diabetes.
A retrospective cohort analysis was conducted using data from four Ontario hospitals. Women who delivered a viable infant between 1 April 2008 and 31 March 2010 were included in the study. Unadjusted and adjusted odds ratios were calculated for each outcome measure and were used to compare the breastfeeding rates among women with and without diabetes.
After controlling for potential confounders, women with insulin-treated diabetes were less likely to intend to breastfeed, when compared with women without diabetes (adjusted odds ratio 0.49, 95% CI 0.27-0.89). In hospital, women with insulin-treated diabetes were least likely to breastfeed (odds ratio 0.42, 95% CI 0.26-0.67), followed by women with non-insulin-treated diabetes (odds ratio 0.50, 95% CI 0.26-0.96) and women with gestational diabetes (odds ratio 0.77, 95% CI 0.68-0.87) when compared with women without diabetes. On discharge, women with insulin-treated diabetes were least likely to breastfeed (odds ratio 0.38, 95% CI 0.24-0.60), followed by women with gestational diabetes (odds ratio 0.75, 95% CI 0.66-0.85); rates of breastfeeding among women with non-insulin-treated diabetes were comparable on discharge with those of women without diabetes. Women seeking care from an antenatal provider other than a physician were 2-3 times more likely to breastfeed in hospital and on discharge.
Women with insulin-treated diabetes had the poorest outcomes with respect to breastfeeding rates. Gestational and non-insulin-treated diabetes were associated with lower rates of breastfeeding in hospital, while gestational diabetes was additionally associated with lower breastfeeding rates on discharge.
探讨患有孕前或妊娠期糖尿病或无糖尿病的女性在医院和出院时的母乳喂养意愿和母乳喂养率。
使用安大略省四家医院的数据进行回顾性队列分析。研究纳入了 2008 年 4 月 1 日至 2010 年 3 月 31 日期间分娩活婴的女性。计算了每个结果测量的未调整和调整后的优势比，并用于比较有糖尿病和无糖尿病女性的母乳喂养率。
在控制了潜在的混杂因素后，与无糖尿病的女性相比，接受胰岛素治疗的糖尿病女性母乳喂养的意愿较低（调整后的优势比 0.49，95%置信区间 0.27-0.89）。在医院，接受胰岛素治疗的糖尿病女性最不可能进行母乳喂养（比值比 0.42，95%置信区间 0.26-0.67），其次是未接受胰岛素治疗的糖尿病女性（比值比 0.50，95%置信区间 0.26-0.96）和妊娠期糖尿病女性（比值比 0.77，95%置信区间 0.68-0.87）。出院时，接受胰岛素治疗的糖尿病女性最不可能进行母乳喂养（比值比 0.38，95%置信区间 0.24-0.60），其次是妊娠期糖尿病女性（比值比 0.75，95%置信区间 0.66-0.85）；未接受胰岛素治疗的糖尿病女性的母乳喂养率与无糖尿病女性出院时的母乳喂养率相当。从产前提供者处寻求护理的女性，如果不是医生，那么她们在医院和出院时母乳喂养的可能性是 2-3 倍。
患有胰岛素治疗糖尿病的女性在母乳喂养率方面的结果最差。妊娠期和未接受胰岛素治疗的糖尿病与医院内母乳喂养率较低相关，而妊娠期糖尿病还与出院时母乳喂养率较低相关。
