Garthus-Niegel Susan, Horsch Antje, Ayers Susan, Junge-Hoffmeister Juliane, Weidner Kerstin, Eberhard-Gran Malin
Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine of the Technische Universität Dresden, Dresden, Germany.
Department of Child Health, Norwegian Institute of Public Health, Oslo, Norway.
Birth. 2018 Jun;45(2):193-201. doi: 10.1111/birt.12328. Epub 2017 Dec 18.
In most Western countries, breastfeeding rates are lower than what is recommended by the World Health Organization. Depression has been shown to influence breastfeeding outcomes; however, there is very little research on the role of postpartum posttraumatic stress disorder (PTSD). This study examined to what extent maternal postpartum PTSD predicted breastfeeding initiation, exclusive breastfeeding during the first 6 months, and continuation up to 1 and 2 years.
The study is part of the large, population-based Akershus Birth Cohort. Data from the hospital's birth record and questionnaire data from 8 weeks and 2 years postpartum were used (n = 1480). All breastfeeding variables significantly correlated with postpartum PTSD were entered into stepwise logistic regression analyses.
Although most mothers (97.1%) initiated breastfeeding, considerably fewer adhered to the World Health Organization's breastfeeding guidelines about exclusive breastfeeding during the first 6 months (13.4%) or continued breastfeeding for 12 or 24 months postpartum (37.7% and 4.2%, respectively). Even after adjustment for important confounding variables, maternal postpartum PTSD was significantly associated with not initiating breastfeeding (aOR 5.98 [95% CI 1.79-19.97]). Postpartum PTSD was also significantly related to not continuing breastfeeding up to 12 months, although this association did not hold after adjusting for confounding variables.
Identifying women at risk of not initiating breastfeeding is crucial to prevent a negative influence on infant development and the development of the mother-infant bond. Early screening and treatment of women at risk of developing postpartum PTSD might be a way forward.
在大多数西方国家，母乳喂养率低于世界卫生组织的建议水平。抑郁症已被证明会影响母乳喂养结果；然而，关于产后创伤后应激障碍（PTSD）作用的研究非常少。本研究调查了母亲产后PTSD在多大程度上预测了母乳喂养的开始、前6个月的纯母乳喂养以及持续到1年和2年的情况。
该研究是基于阿克什胡斯郡大规模人群的出生队列研究的一部分。使用了医院的出生记录数据以及产后8周和2年的问卷调查数据（n = 1480）。所有与产后PTSD显著相关的母乳喂养变量都被纳入逐步逻辑回归分析。
尽管大多数母亲（97.1%）开始母乳喂养，但只有相当少的人遵循世界卫生组织关于前6个月纯母乳喂养的指导方针（13.4%），或在产后12个月或24个月继续母乳喂养（分别为37.7%和4.2%）。即使在调整了重要的混杂变量后，母亲产后PTSD仍与未开始母乳喂养显著相关（调整后比值比5.98 [95%置信区间1.79 - 19.97]）。产后PTSD也与未持续母乳喂养至12个月显著相关，尽管在调整混杂变量后这种关联不再成立。
识别有不开始母乳喂养风险的女性对于防止对婴儿发育和母婴关系发展产生负面影响至关重要。对有发展为产后PTSD风险的女性进行早期筛查和治疗可能是一条出路。
