Zhao Jian, Zhao Yun, Binns Colin W, Lee Andy H
School of Public Health, Curtin University, Perth 6102, Australia.
Nutrients. 2016 Oct 9;8(10):622. doi: 10.3390/nu8100622.
The calcium supplementation status during the postpartum period among Chinese lactating women is still unclear. The objective of this study is to utilize data from two population-based prospective cohort studies to examine the calcium supplementation status and to identify whether breastfeeding is associated with increased calcium supplementation among Chinese mothers after child birth. Information from 1540 mothers on breastfeeding and calcium supplementation measured at discharge, 1, 3, and 6 months postpartum were extracted to evaluate the association between breastfeeding and calcium supplementation postpartum. A generalized linear mixed model was applied to each study initially to account for the inherent correlation among repeated measurements, adjusting for socio-demographic, obstetric factors and calcium supplementation during pregnancy. In addition, breastfeeding status measured at different follow-up time points was treated as a time dependent variable in the longitudinal analysis. Furthermore, the effect sizes of the two cohort studies were pooled using fixed effect model. Based on the two cohort studies, the pooled likelihood of taking calcium supplementation postpartum among breastfeeding mothers was 4.02 times (95% confidence interval (2.30, 7.03)) higher than that of their non-breastfeeding counterparts. Dietary supplementation intervention programs targeting different subgroups should be promoted in Chinese women, given currently a wide shortage of dietary calcium intake and calcium supplementation postpartum.
中国哺乳期妇女产后的补钙状况仍不明确。本研究的目的是利用两项基于人群的前瞻性队列研究的数据,来检查补钙状况,并确定母乳喂养是否与中国母亲产后补钙增加有关。提取了1540名母亲在出院时、产后1个月、3个月和6个月时测量的母乳喂养和补钙信息,以评估母乳喂养与产后补钙之间的关联。最初对每项研究应用广义线性混合模型,以考虑重复测量之间的内在相关性,并对社会人口统计学、产科因素和孕期补钙情况进行调整。此外,在纵向分析中,将不同随访时间点测量的母乳喂养状况作为一个随时间变化的变量。此外,使用固定效应模型汇总两项队列研究的效应量。基于这两项队列研究,母乳喂养母亲产后补钙的合并可能性比非母乳喂养母亲高4.02倍(95%置信区间(2.30, 7.03))。鉴于目前中国女性膳食钙摄入量和产后补钙普遍不足,应针对不同亚组推广膳食补充干预项目。