Cordero Leandro, Oza-Frank Reena, Landon Mark B, Nankervis Craig A
1 Department of Pediatrics, The Ohio State University , Columbus, Ohio.
2 Center for Perinatal Research, Nationwide Children's Hospital , Columbus, Ohio.
Breastfeed Med. 2015 Jun;10(5):239-45. doi: 10.1089/bfm.2015.0028. Epub 2015 May 14.
Women who are overweight or obese are at risk for maternal and neonatal medical complications, including macrosomia (birth weight ≥4,000 g), that may contribute to breastfeeding initiation failure. This study examined factors associated with breastfeeding initiation among obese women without diabetes who delivered macrosomic infants.
A retrospective chart review was conducted from 2008 to 2011. Based on prepregnancy body mass index (in kg/m(2)), women were classified as normal (18-24.9), overweight (25-29.9), obese (30-34.9), very obese (35-39.9), and extremely obese (≥40). Intention to breastfeed was ascertained prenatally, and breastfeeding initiation was defined if at discharge ≥50% of the infant feedings were breastmilk.
Twenty-nine percent of the population was overweight, 23% obese, 14% very obese, and 12% extremely obese. Intention to breastfeed was similar among normal-weight, overweight, obese, and very obese women but was significantly lower for those who were extremely obese (p<0.05). Breastfeeding initiation was 75% for normal-weight, 72% for overweight, 71% for obese, 66% for very obese, and 53% for extremely obese women (p<0.05). Among women who intended to breastfeed, breastfeeding initiation was uniformly high: 94% for normal-weight, 93% for overweight, 95% for obese, 92% for very obese, and 87% for extremely obese women.
Intention to breastfeed as well as breastfeeding initiation was significantly lower for extremely obese women. Lack of intention to breastfeed declared during the antepartum period by extremely obese women highlights a need as well as an opportunity for intervention.
超重或肥胖的女性存在孕产妇和新生儿医学并发症风险，包括巨大儿（出生体重≥4000克），这可能导致母乳喂养开始失败。本研究调查了分娩巨大儿的非糖尿病肥胖女性中与母乳喂养开始相关的因素。
对2008年至2011年的病历进行回顾性分析。根据孕前体重指数（kg/m²），女性被分为正常体重（18 - 24.9）、超重（25 - 29.9）、肥胖（30 - 34.9）、极度肥胖（35 - 39.9）和超级肥胖（≥40）。产前确定母乳喂养意愿，若出院时≥50%的婴儿喂养为母乳，则定义为开始母乳喂养。
29%的人群超重，23%肥胖，14%极度肥胖，12%超级肥胖。正常体重、超重、肥胖和极度肥胖女性的母乳喂养意愿相似，但超级肥胖女性的意愿显著较低（p<0.05）。正常体重女性的母乳喂养开始率为75%，超重女性为72%，肥胖女性为71%，极度肥胖女性为66%，超级肥胖女性为53%（p<0.05）。在打算母乳喂养的女性中，母乳喂养开始率普遍较高：正常体重女性为94%，超重女性为93%，肥胖女性为95%，极度肥胖女性为92%，超级肥胖女性为87%。
超级肥胖女性的母乳喂养意愿和开始率显著较低。超级肥胖女性在产前声明无意母乳喂养，这凸显了干预的必要性和机会。
