Ramji Naila, Challa Satyadeva, Murphy Phil A, Quinlan James, Crane Joan M G
a Department of Obstetrics and Gynecology , Memorial University of Newfoundland , St. John's , Canada.
b Newfoundland and Labrador Support Unit Strategy for Patient-Oriented Research (SPOR - CIHR) , Ottawa , Ontario , Canada.
J Matern Fetal Neonatal Med. 2018 Nov;31(22):3021-3026. doi: 10.1080/14767058.2017.1362552. Epub 2017 Aug 11.
The purpose of this study is to compare breastfeeding initiation rates for women across body mass index (BMI) classes, including normal BMI (18.50-24.99 kg/m), overweight (25.00-29.99 kg/m), obese (30.00-39.99 kg/m), morbidly obese (40.00-49.99 kg/m) and extreme obesity (≥50.00 kg/m).
Retrospective cohort of women with singleton pregnancies, delivering in St. John's, NL between 2002 and 2011. The primary outcome was any breastfeeding on hospital discharge. Breastfeeding rates across BMI categories were compared, using univariate analyses. Multivariate analysis included additional maternal and obstetric variables.
Twelve thousand four hundred twenty-two women were included: 8430 breastfed and 3992 did not breastfeed on hospital discharge. Progressively decreasing rates of breastfeeding were noted with increasing obesity class: normal BMI (71.1%), overweight (69.1%), obese (61.6%), morbidly obese (54.2%), and extremely obese women (42.3%). Multivariate analysis confirmed that increasing obesity class resulted in lower odds of breastfeeding: overweight (adjusted odds ratios (aOR) 0.86, 95%CI 0.76-0.98), obese (aOR 0.65, 95%CI 0.57-0.74), morbidly obese (aOR 0.57, 95%CI 0.44-0.74), and extreme obesity (aOR 0.37, 95%CI 0.19-0.74).
Women in higher obesity classes are progressively less likely to initiate breastfeeding. Women with the highest prepregnancy BMIs should be particularly counseled on the benefits of breastfeeding.
本研究旨在比较不同体重指数（BMI）类别的女性开始母乳喂养的比率，包括正常BMI（18.50 - 24.99千克/平方米）、超重（25.00 - 29.99千克/平方米）、肥胖（30.00 - 39.99千克/平方米）、病态肥胖（40.00 - 49.99千克/平方米）和极度肥胖（≥50.00千克/平方米）。
对2002年至2011年期间在加拿大纽芬兰与拉布拉多省圣约翰市分娩单胎的女性进行回顾性队列研究。主要结局是出院时是否进行母乳喂养。使用单因素分析比较不同BMI类别的母乳喂养率。多因素分析纳入了其他产妇和产科变量。
共纳入12422名女性：8430名在出院时进行母乳喂养，3992名未进行母乳喂养。随着肥胖等级的增加，母乳喂养率逐渐下降：正常BMI（71.1%）、超重（69.1%）、肥胖（61.6%）、病态肥胖（54.2%）和极度肥胖女性（42.3%）。多因素分析证实，肥胖等级增加会导致母乳喂养的几率降低：超重（调整后的优势比（aOR）0.86，95%置信区间0.76 - 0.98）、肥胖（aOR 0.65，95%置信区间0.57 - 0.74）、病态肥胖（aOR 0.57，95%置信区间0.44 - 0.74）和极度肥胖（aOR 0.37，95%置信区间0.19 - 0.74）。
肥胖等级较高的女性开始母乳喂养的可能性逐渐降低。对于孕前BMI最高的女性，应特别就母乳喂养的益处进行咨询。
