Adedinsewo Demilade A, Fleming Alison S, Steiner Meir, Meaney Michael J, Girard Amy Webb
1Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
J Hum Lact. 2014 Feb;30(1):102-9. doi: 10.1177/0890334413504244. Epub 2013 Sep 24.
Maternal anxiety and depression may impair maternal intention, motivation, and self-efficacy in multiple domains associated with child health including breastfeeding.
We tested the hypothesis that mothers who experience substantial anxiety during pregnancy or the postpartum period are at increased risk for reduced initiation, exclusivity, and continuation of breastfeeding.
We obtained data on 255 Canadian pregnant women from the Maternal Adversity, Vulnerability and Neurodevelopment (MAVAN) study recruited between June 2004 and February 2009. We utilized data collected from 18 to 23 weeks gestation through 12 months postpartum. Multivariate logistic regression was used to assess whether scores on the Hamilton Anxiety Scale (HAM-A) and State-Trait Anxiety Inventory (STAI) were associated with initiation, exclusivity, and continuation of breastfeeding.
Prenatal anxiety was not associated with breastfeeding outcomes. In adjusted models, a single point increase in HAM-A scores at 3 months postpartum was associated with an 11% reduction in the odds of exclusive breastfeeding at 6 months (adjusted odds ratio [aOR] = 0.89; 95% CI, 0.80-0.99). A single point increase in STAI State and STAI Trait scores at 3 months postpartum was associated with a 4% (aOR = 0.96; 95% CI, 0.92-0.99) and 7% (aOR = 0.93; 95% CI, 0.86-1.00) reduction, respectively, in the odds of any breastfeeding at 12 months.
Our findings suggest a relationship between maternal anxiety and reduced exclusivity and continuation of breastfeeding. Maternal anxiety should be actively monitored and managed appropriately in the postpartum period to support optimal breastfeeding practices.
孕产妇焦虑和抑郁可能会损害孕产妇在包括母乳喂养在内的与儿童健康相关的多个领域中的意愿、动机和自我效能感。
我们检验了这样一个假设，即在孕期或产后经历严重焦虑的母亲进行母乳喂养的开始率、纯母乳喂养率和持续率降低的风险会增加。
我们从2004年6月至2009年2月招募的孕产妇逆境、脆弱性和神经发育（MAVAN）研究中获取了255名加拿大孕妇的数据。我们利用了从妊娠18至23周直至产后12个月收集的数据。采用多因素逻辑回归分析来评估汉密尔顿焦虑量表（HAM - A）和状态 - 特质焦虑问卷（STAI）的得分是否与母乳喂养的开始、纯母乳喂养和持续情况相关。
产前焦虑与母乳喂养结果无关。在调整后的模型中，产后3个月时HAM - A得分每增加1分，6个月时纯母乳喂养几率降低11%（调整后的优势比[aOR]=0.89；95%置信区间[CI]，0.80 - 0.99）。产后3个月时STAI状态量表和STAI特质量表得分每增加1分，分别与12个月时任何形式母乳喂养几率降低4%（aOR = 0.96；95% CI，$0.92 - 0.99$）和7%（aOR = 0.93；95% CI，$0.86 - 1.00$）相关。
我们的研究结果表明孕产妇焦虑与纯母乳喂养率降低和母乳喂养持续情况之间存在关联。在产后应积极监测并适当管理孕产妇焦虑，以支持最佳母乳喂养实践。
