Balyakina Elizabeth, Fulda Kimberly G, Franks Susan F, Cardarelli Kathryn M, Hinkle Kollier
Department of Family Medicine, Texas College of Osteopathic Medicine, University of North Texas Health Science Center (UNTHSC), Fort Worth, TX, USA.
North Texas Primary Care Practice-Based Research Network (NorTex), University of North Texas Health Science Center (UNTHSC), Fort Worth, TX, USA.
Matern Child Health J. 2016 May;20(5):993-1000. doi: 10.1007/s10995-015-1884-x.
The primary purpose of this study was to determine the association between type of healthcare provider delivering prenatal care and intent to exclusively breastfeed.
A self-report survey was administered to 455 expectant mothers. Logistic regression was performed to determine the association between prenatal care provider type [obstetrician; other primary care physician (family doctor/general practitioner/internist/or other physician); midwife/nurse midwife; more than one provider; and other] with intent to breastfeed (exclusive/non-exclusive).
Having a midwife/nurse midwife as a prenatal care provider was associated with intent to breastfeed compared to having an obstetrician (OR 2.544, 95 % CI 1.385-4.675). There was no difference in intent between women with another primary care physician and an obstetrician. Women with another type of health care provider, no prenatal care from a health professional, or no knowledge of who is providing prenatal care were less likely to intend to breastfeed (OR 0.228, CI 0.068-0.766) as compared to those with an obstetrician.
DISCUSSION/CONCLUSIONS: Provider type is associated with intent to breastfeed among pregnant women. Women's intent to breastfeed is an important predictor of breastfeeding initiation, continuation, and duration that may be assessed by healthcare providers during the prenatal period. A consideration of what features of provider care are associated with improved breastfeeding outcomes and characteristics of women seeking prenatal care with midwives may serve to formulate future prenatal care policies and education during prenatal care visits.
本研究的主要目的是确定提供产前护理的医疗服务提供者类型与纯母乳喂养意愿之间的关联。
对455名准妈妈进行了一项自我报告调查。采用逻辑回归分析来确定产前护理提供者类型（产科医生；其他初级保健医生（家庭医生/全科医生/内科医生/或其他医生）；助产士/护士助产士；多个提供者；以及其他）与母乳喂养意愿（纯母乳喂养/非纯母乳喂养）之间的关联。
与由产科医生提供产前护理相比，由助产士/护士助产士提供产前护理与母乳喂养意愿相关（比值比2.544，95%置信区间1.385 - 4.675）。有其他初级保健医生的女性与有产科医生的女性在母乳喂养意愿上没有差异。与由产科医生提供产前护理的女性相比，有其他类型医疗服务提供者、未接受医疗专业人员的产前护理或不知道谁在提供产前护理的女性进行母乳喂养的可能性较小（比值比0.228，置信区间0.068 - 0.766）。
讨论/结论：提供者类型与孕妇的母乳喂养意愿相关。女性的母乳喂养意愿是母乳喂养开始、持续和持续时间的重要预测因素，医疗服务提供者可在产前期间对其进行评估。考虑提供者护理的哪些特征与改善母乳喂养结果相关，以及寻求助产士产前护理的女性的特征，可能有助于制定未来产前护理期间的产前护理政策和教育。
