Stopenski Stephen, Aslam Anum, Zhang Xinmin, Cardonick Elyce
1 Department of Obstetrics and Gynecology, Cooper Medical School at Rowan University , Camden, New Jersey.
2 Department of Pathology, Cooper University Hospital , Camden, New Jersey.
Breastfeed Med. 2017 Mar;12:91-97. doi: 10.1089/bfm.2016.0166. Epub 2017 Feb 7.
To report breastfeeding complaints of women diagnosed with cancer during pregnancy and correlate success with characteristics of their treatment.
This is a prospective cohort study of women diagnosed with cancer during pregnancy who attempted breastfeeding. We surveyed participants about breast engorgement, milk let down, and consistent breast milk production through mailed questionnaires. Treatment details, including the type and number of chemotherapy cycles given during pregnancy and antepartum or postpartum depression, were collected. A single pathologist evaluated surgical specimens to note lactational changes while blinded to patient's treatment. The primary endpoint was successful breastfeeding without reporting any lack of or decreased breast milk production.
When comparing women who underwent chemotherapy during pregnancy to women who did not, there was a significant difference in reporting a lack of or a perceived decrease in breast milk supply and the need to provide supplemental feeding to their infants (63.5% and 9%, respectively, p < 0.001). In the women who received chemotherapy, there was no significant difference in maternal age, cancer type, or stage with regard to breastfeeding difficulties. Gestational age at the first cycle and the number of cycles were significant factors associated with breastfeeding difficulties (p = 0.006 and p = 0.0003, respectively). Antepartum and postpartum depression was not associated with decreased breast milk production. A lack of lactational changes and significant lobular atrophy were noted in the women given neoadjuvant chemotherapy.
Women who undergo chemotherapy during a pregnancy are more likely to report breastfeeding difficulties.
报告孕期被诊断患有癌症的女性的母乳喂养问题，并将成功情况与其治疗特征相关联。
这是一项对孕期被诊断患有癌症且尝试进行母乳喂养的女性的前瞻性队列研究。我们通过邮寄问卷对参与者进行了关于乳房胀痛、乳汁排出及持续产奶情况的调查。收集了治疗细节，包括孕期给予的化疗周期类型和数量以及产前或产后抑郁情况。由一名病理学家在对患者治疗情况不知情的情况下评估手术标本，以记录泌乳变化。主要终点是成功进行母乳喂养且未报告任何乳汁分泌不足或减少的情况。
将孕期接受化疗的女性与未接受化疗的女性进行比较时，在报告乳汁供应不足或感觉乳汁减少以及需要给婴儿提供补充喂养方面存在显著差异（分别为63.5%和9%，p < 0.001）。在接受化疗的女性中，母乳喂养困难在产妇年龄、癌症类型或分期方面无显著差异。首个化疗周期时的孕周和化疗周期数是与母乳喂养困难相关的显著因素（分别为p = 0.006和p = 0.0003）。产前和产后抑郁与乳汁分泌减少无关。在接受新辅助化疗的女性中，观察到缺乏泌乳变化和明显的小叶萎缩。
孕期接受化疗的女性更有可能报告母乳喂养困难。
