Bigman Galya, Wilkinson Anna V, Homedes Nuria, Pérez Adriana
Epidemiology, Human Genetics & Environmental Sciences, School of Public Health, The University of Texas Health Science Center at Houston, Austin Regional Campus, 1616 Guadalupe, Austin, TX, 78701, USA.
Management Policy and Community Health, School of Public Health, University of Texas, El Paso, TX, USA.
Matern Child Health J. 2018 Dec;22(12):1815-1825. doi: 10.1007/s10995-018-2583-1.
Introduction In Mexico the breastfeeding rate is low and the obesity rate is high. Body image concerns, particularly prevalent in obese women, are associated with low breastfeeding rate; however, this association has never been examined in Mexican women. To fill this need, we examined the association between body image dissatisfaction (BID) and breastfeeding across levels of maternal weight status in Mexican women. Methods A cross-sectional study was used, utilizing data from the Mexican National Health and Nutrition Survey (ENSANUT) for 2012. The breastfeeding (Never or breastfed less than 30 days, Still breastfeeding, Ever breastfed) of the last child (age ≤ 3 years), BID (Stunkard Figure Rating Scale), anthropometric (Body Mass Index, BMI), and associated characteristics were collected. Weighted-multinomial logistic regression models were utilized to examine the adjusted association between BID and breastfeeding and the effect modification of maternal weight status. Results Overall, 2422 women aged 20-49 years met the eligibility criteria. Of these, 247 (10.8%) had never breastfed or breastfed less than 30 days, 826 (32%) were still breastfeeding, and 1349 (57.2%) had breastfed. A total of 38.2% were overweight (25 ≤ BMI < 30 kg m) and 26.2% were obese (BMI ≥ 30 kg m). In the adjusted model, while stratifying by maternal weight status levels, a greater BID was associated with a lower odds of sill breastfeeding (OR 0.58, 95% CI 0.45-0.75) and having breastfed (OR 0.65, 95% CI 0.50-0.83) only among women with BMI ≥ 30 kg m. Discussion The results highlight the potential relationship between body image concerns and breastfeeding in Mexican women with obesity. However, the causality of such relationship needs further investigation, ideally using a longitudinal study design.
引言 在墨西哥，母乳喂养率较低而肥胖率较高。对身体形象的担忧在肥胖女性中尤为普遍，且与低母乳喂养率相关；然而，这种关联从未在墨西哥女性中得到研究。为满足这一需求，我们研究了墨西哥女性中身体形象不满（BID）与不同体重状况水平下母乳喂养之间的关联。
方法 采用横断面研究，利用2012年墨西哥国家健康与营养调查（ENSANUT）的数据。收集了最后一个孩子（年龄≤3岁）的母乳喂养情况（从未或母乳喂养少于30天、仍在母乳喂养、曾经母乳喂养）、BID（斯图卡德体型评定量表）、人体测量数据（体重指数，BMI）及相关特征。采用加权多项逻辑回归模型来研究BID与母乳喂养之间的校正关联以及母亲体重状况的效应修正。
结果 总体而言，2422名年龄在20至49岁之间的女性符合纳入标准。其中，247名（10.8%）从未母乳喂养或母乳喂养少于30天，826名（32%）仍在母乳喂养，1349名（57.2%）曾经母乳喂养。共有38.2%超重（25≤BMI＜30kg/m），26.2%肥胖（BMI≥30kg/m）。在校正模型中，按母亲体重状况水平分层时，仅在BMI≥30kg/m的女性中，更高的BID与仍在母乳喂养的较低几率（OR 0.58，95%CI 0.45 - 0.75）和曾经母乳喂养的较低几率（OR 0.65，95%CI 0.50 - 0.83）相关。
讨论 结果突出了墨西哥肥胖女性中身体形象担忧与母乳喂养之间的潜在关系。然而，这种关系的因果性需要进一步研究，理想情况下采用纵向研究设计。
