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中国西南部癫痫母亲的母乳喂养起始情况、持续时间及纯母乳喂养情况

Breastfeeding initiation, duration and exclusivity in mothers with epilepsy from South West China.

作者信息

Hao Nanya, Jiang Han, Wu Mengqian, Pan Tianying, Yan Bo, Liu Jie, Mu Jie, Liu Wenyu, Li Jinmei, O'Brien Terence J, Chen Zhibin, Vajda Frank, Zhou Dong

机构信息

Department of Neurology, West China Hospital, University of Sichuan, Chengdu, 610041, China.

Department of Obstetrics and Gynecology, West China Second University Hospital, Chengdu, 610041, China.

出版信息

Epilepsy Res. 2017 Sep;135:168-175. doi: 10.1016/j.eplepsyres.2017.06.015. Epub 2017 Jun 30.

Abstract

PURPOSES

  1. To study the breastfeeding initiation, duration and exclusivity rates, and common reasons for early weaning in Chinese mothers with epilepsy (MWE); 2) To identify potential perinatal breastfeeding correlations with selected sociodemographic and clinical factors.

METHODS

A semi-structured questionnaire was administered to 281 MWE attending hospitals in South-west China from February 2014 to July 2015. Data about breastfeeding behaviors, sociodemographic, obstetric, and epileptic variables were collected. Descriptive analyses, followed by univariate and multivariate logistic regression analyses, were utilized to examine associations with breastfeeding, its duration and exclusivity.

RESULTS

Breastfeeding initiation rate in MWE was 59.4%. At 3 months post partum total breastfeeding rate was 49.5% and exclusive breastfeeding rate was 36.3%. At 6 months, about one third (33.1%) of MWE had continued breastfeeding their babies and 12.8% of enrolled infants were exclusively breastfed. During lactation, fear of exposure of the babies to antiepileptic drugs (AEDs) via breast milk, frequent seizures, and insufficient breast milk supply were the commonest reasons for early cessation of breastfeeding. Mothers with epilepsy who had babies delivered at full term were more inclined to breastfeed their babies. Mothers who had gestational non-active epilepsy were more likely to engage in long-term breastfeeding. AED polytherapy was associated with poor breastfeeding behaviors in all aspects.

CONCLUSION

MWE in our study had a lower prevalence of breastfeeding than what would be expected in the general population, where approximately 95% breastfeed. Good seizure control and optimal antiepileptic therapy during gestation and lactation were associated with a higher rate of breastfeeding. Targeted intervention programs enhancing antenatal care services and breastfeeding consultation are needed.

摘要

目的

1)研究中国癫痫母亲(MWE)的母乳喂养起始率、持续时间和纯母乳喂养率,以及早期断奶的常见原因;2)确定围产期母乳喂养与选定的社会人口统计学和临床因素之间的潜在相关性。

方法

2014年2月至2015年7月,对西南地区281名到医院就诊的MWE进行了半结构化问卷调查。收集了有关母乳喂养行为、社会人口统计学、产科和癫痫变量的数据。采用描述性分析,随后进行单因素和多因素逻辑回归分析,以检验与母乳喂养及其持续时间和纯母乳喂养的相关性。

结果

MWE的母乳喂养起始率为59.4%。产后3个月时,总母乳喂养率为49.5%,纯母乳喂养率为36.3%。6个月时,约三分之一(33.1%)的MWE仍在继续母乳喂养婴儿,12.8%的登记婴儿为纯母乳喂养。在哺乳期间,担心婴儿通过母乳接触抗癫痫药物(AEDs)、癫痫发作频繁和母乳供应不足是早期停止母乳喂养的最常见原因。足月分娩婴儿的癫痫母亲更倾向于母乳喂养。患有妊娠期非活动性癫痫的母亲更有可能进行长期母乳喂养。AED联合治疗在各方面均与不良的母乳喂养行为相关。

结论

我们研究中的MWE母乳喂养率低于一般人群预期的约95%的母乳喂养率。妊娠期和哺乳期良好的癫痫控制和最佳的抗癫痫治疗与更高的母乳喂养率相关。需要有针对性的干预计划来加强产前护理服务和母乳喂养咨询。

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