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产后 14 周时更频繁同床睡的女性随后报告母乳喂养时间更长。

Women Who Bedshare More Frequently at 14 Weeks Postpartum Subsequently Report Longer Durations of Breastfeeding.

出版信息

J Midwifery Womens Health. 2018 Jul;63(4):418-424. doi: 10.1111/jmwh.12753. Epub 2018 May 25.

Abstract

INTRODUCTION

Breastfeeding rates in the United States continue to fall short of Healthy People 2020 goals. Bedsharing has been promoted as a way of increasing breastfeeding durations.

METHODS

We used prospectively collected Oregon Pregnancy Risk Assessment Monitoring System (PRAMS) and PRAMS-2 data from 2276 women to explore whether bedsharing frequency predicts age at weaning. Bedsharing was assessed at 14 weeks after birth (PRAMS), and duration of breastfeeding was assessed at 2 years after birth (PRAMS-2). Cox proportional hazards models controlled for primiparity, cesarean birth, marital status, employment status, maternal race and ethnicity, and pregravid body mass index.

RESULTS

Women in this sample reported high rates of bedsharing: only 15.7% of PRAMS respondents said they never shared a bed with their infant. We also observed a dose-response association between bedsharing frequency and breastfeeding duration when the analysis controlled for covariables: women who reported more frequent bedsharing at 14 weeks postpartum were more likely to wean later. Hazard ratios ranged from 1.18 (95% CI, 1.02-1.35) for "often" versus "always" bedsharing to 1.92 (95% CI, 1.66-2.24) for "never" versus "always." In other words, at any given infant age, women who always bedshared were more likely to keep breastfeeding. Women who always bedshared at 14 weeks postpartum breastfed their infant for a median of 13 months (95% CI, 12-14), compared with 10 months (95% CI, 9-11) for women who never bedshared at 14 weeks.

DISCUSSION

Although we cannot rule out confounding by breastfeeding intention, our results suggest that bedsharing in early infancy might lead to later weaning. Regardless of infant feeding method, given the frequency of bedsharing reported by women in this and other samples, clinicians encountering pregnant and postpartum women should teach safe bedsharing practices.

摘要

简介

美国的母乳喂养率继续低于《2020 年健康人民》的目标。同床共睡已被推广为增加母乳喂养时间的一种方式。

方法

我们使用前瞻性收集的俄勒冈州妊娠风险评估监测系统(PRAMS)和 PRAMS-2 数据,对 2276 名女性进行了研究,以探讨同床共睡的频率是否能预测断奶年龄。在产后 14 周(PRAMS)评估同床共睡情况,在产后 2 年(PRAMS-2)评估母乳喂养时间。Cox 比例风险模型控制了初产妇、剖宫产、婚姻状况、就业状况、产妇种族和民族以及孕前体重指数等因素。

结果

在该样本中,女性报告的同床共睡率很高:只有 15.7%的 PRAMS 受访者表示他们从未与婴儿同床。当分析控制了协变量时,我们还观察到同床共睡频率与母乳喂养时间之间存在剂量反应关系:产后 14 周报告更频繁同床共睡的女性更有可能晚些断奶。风险比范围从“经常”与“总是”同床共睡的 1.18(95%CI,1.02-1.35)到“从不”与“总是”同床共睡的 1.92(95%CI,1.66-2.24)。换句话说,在任何给定的婴儿年龄,总是同床共睡的女性更有可能继续母乳喂养。产后 14 周时总是同床共睡的女性母乳喂养中位数为 13 个月(95%CI,12-14),而产后 14 周时从不同床共睡的女性为 10 个月(95%CI,9-11)。

讨论

尽管我们不能排除母乳喂养意图的混杂因素,但我们的结果表明,婴儿早期同床共睡可能导致晚些断奶。无论婴儿喂养方式如何,鉴于本研究和其他研究样本中女性报告的同床共睡频率,临床医生在遇到孕妇和产后女性时,应该教授安全的同床共睡做法。

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