Morrison M K, Collins C E, Lowe J M, Giglia R C
Health & Education Services, Diabetes NSW, Glebe, NSW 2037, Australia.
School of Health Sciences, Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, Callaghan, NSW 2308, Australia.
Women Birth. 2015 Jun;28(2):143-7. doi: 10.1016/j.wombi.2014.12.002. Epub 2015 Jan 22.
To determine factors associated with early cessation of breastfeeding (≤ 3 months) in women with recent gestational diabetes mellitus (GDM).
A cross-sectional online survey of women aged ≥ 18 years, diagnosed with GDM in 2010 and registered with the National Diabetes Services Scheme in Australia. The 59 questions examined breastfeeding duration, intention, attitudes, exclusivity and support.
738 women completed the survey (15% response rate). Data was analysed for 729 eligible respondents. Of these 97% reported 'ever' breastfeeding and 19% had breastfed for ≤ 3 months. Cessation of breastfeeding at or before 3 months was associated with breastfeeding problems at home [adjusted odds ratio 8.01, 95% confidence interval (4.57, 14.05)], return to work prior to three months [OR 3.39 (95% CI 1.53, 7.55)], inadequate breastfeeding support [OR 1.88 (95% CI 1.10, 3.22)], caesarean delivery [OR 1.70 (95% CI 1.04, 2.76)], low socioeconomic status (SEIFA 1 unit increase) [OR 0.89 (95% CI 0.81, 0.97)] and BMI (2 unit increase) [OR 1.08 (95% CI 1.01, 1.57)]. Being married or de facto [OR 0.14 (95% CI 0.03, 0.62)] was a protective against early cessation of breastfeeding.
Strategies to improve breastfeeding duration in women with GDM need to address those most at risk of early cessation and provide appropriate postpartum breastfeeding support in this group.
确定近期患有妊娠期糖尿病（GDM）的女性早期停止母乳喂养（≤3个月）的相关因素。
对2010年被诊断为GDM并在澳大利亚国家糖尿病服务计划登记的18岁及以上女性进行横断面在线调查。59个问题涉及母乳喂养持续时间、意愿、态度、纯母乳喂养情况及支持情况。
738名女性完成了调查（回复率15%）。对729名符合条件的受访者进行了数据分析。其中97%报告“曾经”母乳喂养，19%母乳喂养≤3个月。在3个月及之前停止母乳喂养与家庭中母乳喂养问题相关[调整比值比8.01，95%置信区间（4.57，14.05）]、3个月之前返回工作岗位[比值比3.39（95%置信区间1.53，7.55）]、母乳喂养支持不足[比值比1.88（95%置信区间1.10，3.22）]、剖宫产[比值比1.70（95%置信区间1.04，2.76）]、低社会经济地位（社会经济指数增加1个单位）[比值比0.89（95%置信区间0.81，0.97）]及体重指数（增加2个单位）[比值比1.08（95%置信区间1.01，1.57）]有关。已婚或事实婚姻状态[比值比0.14（95%置信区间0.03，0.62）]可预防早期停止母乳喂养。
改善GDM女性母乳喂养持续时间的策略需要针对那些早期停止母乳喂养风险最高的人群，并为该群体提供适当的产后母乳喂养支持。
