Silva Catarine S, Lima Marilia C, Sequeira-de-Andrade Leopoldina A S, Oliveira Juliana S, Monteiro Jailma S, Lima Niedja M S, Santos Rijane M A B, Lira Pedro I C
Centro Acadêmico de Vitória, Universidade Federal de Pernambuco (UFPE), Núcleo de Nutrição, Vitória de Santo Antão, PE, Brazil.
Universidade Federal de Pernambuco (UFPE), Departamento Materno Infantil, Recife, PE, Brazil.
J Pediatr (Rio J). 2017 Jul-Aug;93(4):356-364. doi: 10.1016/j.jped.2016.08.005. Epub 2016 Dec 26.
To investigate the association between postpartum depression and the occurrence of exclusive breastfeeding.
This is a cross-sectional study conducted in the states of the Northeast region, during the vaccination campaign in 2010. The sample consisted of 2583 mother-child pairs, with children aged from 15 days to 3 months. The Edinburgh Postnatal Depression Scale was used to screen for postpartum depression. The outcome was lack of exclusive breastfeeding, defined as the occurrence of this practice in the 24h preceding the interview. Postpartum depression was the explanatory variable of interest and the covariates were: socioeconomic and demographic conditions; maternal health care; prenatal, delivery, and postnatal care; and the child's biological factors. Multivariate logistic regression analysis was conducted to control for possible confounding factors.
Exclusive breastfeeding was observed in 50.8% of the infants and 11.8% of women had symptoms of postpartum depression. In the multivariate logistic regression analysis, a higher chance of exclusive breastfeeding absence was found among mothers with symptoms of postpartum depression (OR=1.67; p<0.001), among younger subjects (OR=1.89; p<0.001), those who reported receiving benefits from the Bolsa Família Program (OR=1.25; p=0.016), and those started antenatal care later during pregnancy (OR=2.14; p=0.032).
Postpartum depression contributed to reducing the practice of exclusive breastfeeding. Therefore, this disorder should be included in the prenatal and early postpartum support guidelines for breastfeeding, especially in low socioeconomic status women.
探讨产后抑郁与纯母乳喂养发生率之间的关联。
这是一项于2010年在东北地区各州开展的疫苗接种活动期间进行的横断面研究。样本包括2583对母婴，儿童年龄在15天至3个月之间。采用爱丁堡产后抑郁量表筛查产后抑郁。结局指标为未进行纯母乳喂养，定义为在访谈前24小时内出现该情况。产后抑郁是感兴趣的解释变量，协变量包括：社会经济和人口统计学状况；孕产妇保健；产前、分娩和产后护理；以及儿童的生物学因素。进行多因素逻辑回归分析以控制可能的混杂因素。
50.8%的婴儿进行了纯母乳喂养，11.8%的女性有产后抑郁症状。在多因素逻辑回归分析中，有产后抑郁症状的母亲（OR=1.67；p<0.001）、较年轻的受试者（OR=1.89；p<0.001）、报告领取家庭补助金计划福利的母亲（OR=1.25；p=0.016）以及在孕期较晚开始产前检查的母亲（OR=2.14；p=0.032）中，未进行纯母乳喂养的可能性更高。
产后抑郁导致纯母乳喂养率降低。因此，这种疾病应纳入母乳喂养的产前和产后早期支持指南，尤其是在社会经济地位较低的女性中。
