Fryer Kimberly, Santos Hudson P, Pedersen Cort, Stuebe Alison M
1 Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill , Chapel Hill, North Carolina.
2 School of Nursing, University of North Carolina at Chapel Hill , Chapel Hill, North Carolina.
Breastfeed Med. 2018 Apr;13(3):174-180. doi: 10.1089/bfm.2017.0157. Epub 2018 Feb 27.
Breastfeeding has multiple benefits for both mother and infant. Previous studies have shown that Hispanic/Latina women have higher rates of breastfeeding and better health outcomes than non-Hispanic black (NHB) women of similar socioeconomic status. Our primary objective was to explore the association of race/ethnicity with breastfeeding rates and the impact of socioeconomic factors on initiation and continuation of breastfeeding.
We performed a hypothesis-generating secondary analysis of a prospective cohort study of perinatal mental health in a diverse sample of 213 mothers. Twenty-eight participants self-identified as non-Hispanic white, 43 as NHB, and 142 as Hispanic/Latina. We examined bivariate relationships and performed logistic regression analysis for a series of maternal, infant, and psychosocial factors to examine their individual effect on the breastfeeding and race/ethnicity relationship odds ratio (OR).
Hispanic/Latina women were more likely to initiate exclusive breastfeeding at delivery compared with NHB women (OR 2.4, 95% confidence interval: 1.2-4.9, p = 0.01). Adjustment for maternal, infant, and psychosocial factors measured did not statistically significantly attenuate the OR for initiation of breastfeeding between NHB and Hispanic/Latina women. Women with a history of sexual abuse were also more likely to initiate exclusive breastfeeding (67%) compared with women without a sexual abuse history (54%, p < 0.05).
In this low socioeconomic status cohort study, Hispanic/Latina women had higher proportions of any amount of breastfeeding compared with their NHB counterparts. This difference was not attenuated by any of the maternal, infant, or psychosocial factors examined, although our secondary analysis of this prospective cohort was limited by the available covariates in the parent study.
母乳喂养对母亲和婴儿都有诸多益处。先前的研究表明，与社会经济地位相似的非西班牙裔黑人（NHB）女性相比，西班牙裔/拉丁裔女性的母乳喂养率更高，健康状况也更好。我们的主要目标是探讨种族/族裔与母乳喂养率之间的关联，以及社会经济因素对母乳喂养开始和持续的影响。
我们对一项关于围产期心理健康的前瞻性队列研究进行了假设生成性二次分析，该研究样本多样，共有213名母亲。28名参与者自我认定为非西班牙裔白人，43名是NHB，142名是西班牙裔/拉丁裔。我们检查了双变量关系，并对一系列母亲、婴儿和心理社会因素进行了逻辑回归分析，以检验它们对母乳喂养与种族/族裔关系比值比（OR）的个体影响。
与NHB女性相比，西班牙裔/拉丁裔女性在分娩时更有可能开始纯母乳喂养（OR 2.4，95%置信区间：1.2 - 4.9，p = 0.01）。对所测量的母亲、婴儿和心理社会因素进行调整后，并未在统计学上显著减弱NHB和西班牙裔/拉丁裔女性之间母乳喂养开始的OR。有性虐待史的女性也比没有性虐待史的女性更有可能开始纯母乳喂养（67%对54%，p < 0.05）。
在这项低社会经济地位的队列研究中，与NHB女性相比，西班牙裔/拉丁裔女性进行任何程度母乳喂养的比例更高。尽管我们对这个前瞻性队列的二次分析受到母研究中可用协变量的限制，但所检查的任何母亲、婴儿或心理社会因素都没有减弱这种差异。
