Department of Epidemiology and Medical Statistics, Xiangya School of Public Health, Central South University, Changsha, China.
Breastfeed Med. 2019 Nov;14(9):654-661. doi: 10.1089/bfm.2019.0061. Epub 2019 Aug 1.
With births generated with assisted reproductive techniques (ARTs) increasingly, the effect of ARTs on infant feeding behaviors is an essential topic to explore. However, limited literature focused on this topic. The objective of this study is to examine the effect of ARTs on infant feeding behaviors. Participants, including 41 mothers who conceived with ARTs and 935 conceived spontaneously, were drawn from a prospective birth cohort between January 2015 and December 2015. The participants were followed up at 1, 3, 6, 8, and 12 months postpartum at their residences through a face-to-face interview. Feeding behaviors, including breastfeeding initiation, partial/exclusive breastfeeding duration and formula introduction were assessed using World Health Organization-recommended definitions. Cox and logistic regression models were applied to examine the association of assisted conception with feeding behaviors. Breastfeeding initiation rates were comparable between women who conceived with and without ARTs (70.7% versus 76.0%). Breastfeeding duration and formula introduction were significantly shorter and earlier in assisted conceptions in univariate analyses at 6 months postpartum [crude hazard ratios (HRs), 95% confidence intervals (CIs) 2.02 (1.03-3.84), and 1.63 (1.09-2.44)]. However, after controlling for covariates, assisted conception was only associated with shorter breastfeeding duration at 6 months postpartum [adjusted HR 1.99, 95% CI 1.05-3.80], no significant differences were found in infant feeding outcomes at 12 months postpartum among women with ART conception versus general conception. Mothers who conceived through ARTs with cesarean deliveries were at the highest risks of shorter breastfeeding duration and earlier formula introduction than mothers who conceived spontaneously with vaginal deliveries. Mothers who conceive through ARTs are associated with shorter breastfeeding durations for the first 6 months, compare to mothers who conceive spontaneously. Furthermore, cesarean delivery has a joint effect with the treatment of ARTs on promoting the development of poor feeding behaviors.
随着辅助生殖技术（ART）出生的婴儿数量不断增加，ART 对婴儿喂养行为的影响是一个需要探索的重要课题。然而，相关文献有限。本研究旨在探讨 ART 对婴儿喂养行为的影响。
参与者包括 2015 年 1 月至 12 月期间从一个前瞻性出生队列中抽取的 41 名通过 ART 受孕的母亲和 935 名自然受孕的母亲。通过面对面访谈，在产后 1、3、6、8 和 12 个月时在她们的住所对参与者进行随访。喂养行为，包括母乳喂养开始时间、部分/完全母乳喂养持续时间和配方奶引入，使用世界卫生组织推荐的定义进行评估。应用 Cox 和逻辑回归模型来检查辅助受孕与喂养行为之间的关联。
母乳喂养开始率在通过 ART 受孕和未受孕的女性之间相似（70.7%比 76.0%）。在产后 6 个月的单变量分析中，母乳喂养持续时间和配方奶引入时间在辅助受孕中明显更短和更早[粗危险比（HR），95%置信区间（CI）为 2.02（1.03-3.84）和 1.63（1.09-2.44）]。然而，在校正协变量后，ART 仅与产后 6 个月母乳喂养持续时间较短相关[调整后的 HR 1.99，95%CI 1.05-3.80]，ART 受孕与普通受孕的女性在产后 12 个月时婴儿喂养结局无显著差异。与自然受孕经阴道分娩的母亲相比，经剖宫产分娩的接受 ART 治疗的母亲更有可能出现母乳喂养时间更短和更早引入配方奶的情况。
与自然受孕的母亲相比，接受辅助生殖技术受孕的母亲在前 6 个月母乳喂养时间更短。此外，剖宫产分娩与 ART 治疗联合作用，促进不良喂养行为的发展。
