Division of Nutritional Sciences, Cornell University, Ithaca, NY.
Am J Clin Nutr. 2014 Mar;99(3):524-34. doi: 10.3945/ajcn.113.071191. Epub 2014 Jan 8.
Psychosocial factors influence breastfeeding outcomes, but little is known about these characteristics and how they influence breastfeeding behavior of obese women, who are a group that experiences poor breastfeeding outcomes.
Our objectives were to determine whether 1) maternal prepregnancy body mass index (BMI) is associated with social knowledge of, social influence toward, maternal confidence in, and behavioral beliefs about breastfeeding; 2) BMI and these psychosocial factors predict outcomes of intention to breastfeed, ever breastfed, and the duration of breastfeeding; and 3) BMI and psychosocial factors are associated with these breastfeeding outcomes independent of each other.
Participants (n = 2824) in the Infant Feeding Practices Study II provided data on psychosocial characteristics and breastfeeding outcomes. In this prospective cohort study, data were analyzed by using logistic and proportional hazards regression models.
Prepregnancy BMI was associated with confidence in (P < 0.0001), social influence toward (P = 0.02), and social knowledge of (P < 0.0001) breastfeeding but not with behavioral beliefs about breastfeeding (P = 0.45). Obese women did not differ from under- and normal-weight women in the intention to breastfeed (P = 0.07) but had lower odds of ever breastfeeding (P = 0.04) and were at greater risk of an earlier cessation of exclusive (P = 0.0009) and any (P = 0.03) breastfeeding. Only the association with exclusive breastfeeding remained significant after controlling for psychosocial factors (P = 0.01). All psychosocial factors were positively associated with each breastfeeding outcome.
Despite their intentions to breastfeed, women with high prepregnancy BMI had psychosocial characteristics associated with poor breastfeeding outcomes. However, these characteristics did not fully explain the association between maternal obesity and breastfeeding outcomes.
社会心理因素会影响母乳喂养的结果，但对于肥胖女性的这些特征及其对母乳喂养行为的影响知之甚少，而肥胖女性是母乳喂养结果较差的群体。
我们的目的是确定：1）产妇孕前体重指数（BMI）是否与母乳喂养的社会认知、社会影响、产妇信心和行为信念有关；2）BMI 和这些社会心理因素是否预测母乳喂养的意图、母乳喂养的经历和母乳喂养的持续时间；3）BMI 和社会心理因素是否与这些母乳喂养结果独立相关。
婴儿喂养实践研究 II 的参与者（n=2824）提供了社会心理特征和母乳喂养结果的数据。在这项前瞻性队列研究中，使用逻辑和比例风险回归模型分析数据。
孕前 BMI 与母乳喂养的信心（P<0.0001）、社会影响（P=0.02）和社会认知（P<0.0001）有关，但与母乳喂养的行为信念无关（P=0.45）。与低体重和正常体重的女性相比，肥胖女性母乳喂养的意愿没有差异（P=0.07），但母乳喂养的几率较低（P=0.04），且更早停止纯母乳喂养（P=0.0009）和任何形式的母乳喂养（P=0.03）的风险更大。在控制社会心理因素后，仅与纯母乳喂养的关联仍然显著（P=0.01）。所有社会心理因素都与每个母乳喂养结果呈正相关。
尽管有母乳喂养的意愿，但孕前 BMI 较高的女性具有与不良母乳喂养结果相关的社会心理特征。然而，这些特征并不能完全解释产妇肥胖与母乳喂养结果之间的关系。
