Department of Community Health Sciences, University of Calgary, Calgary, Canada.
Department of Psychiatry, University of Calgary, Calgary, Canada.
J Matern Fetal Neonatal Med. 2022 Mar;35(6):1148-1155. doi: 10.1080/14767058.2020.1743664. Epub 2020 Mar 24.
The prevalence of chronic disease in pregnant women has consistently risen over the past two decades. Substantial evidence demonstrates that maternal chronic disease is associated with adverse medical outcomes like preterm birth, but less research has characterized postpartum outcomes such as infant feeding practices. It is recommended that infants be exclusively breastfed from birth to 6 months given the numerous health benefits it provides.
To determine the association between maternal chronic disease and breastfeeding outcomes.
We analyzed cross-sectional self-report data from the 2015/2016 Canadian Community Health Survey, restricted to women who gave birth within 2 years of data collection ( = 2100, rounded). The exposure was professionally diagnosed chronic physical disease (e.g. diabetes, arthritis, heart disease). The outcomes were breastfeeding non-initiation and early cessation of breastfeeding before 6 months. Multivariable logistic regression modeling was used to estimate adjusted odds ratios (AOR) with 95% confidence intervals (CIs). Estimates were bootstrapped and weighted to represent the national population.
Overall, 11.9% (95% CI 9.8-14.1) of women reported chronic disease, and were more likely to be single, be Canadian born, have low education, and be overweight/obese than women without chronic disease. The mean maternal age was approximately 30 years in both groups. Women with chronic disease had similar odds of breastfeeding non-initiation (AOR 0.96, 95% CI 0.54-1.71) and early cessation of any breastfeeding (AOR 1.40, 95% CI 0.82-2.40), but over twice the odds of early cessation of exclusive breastfeeding (AOR 2.48, 95% CI 1.49-4.12) compared to unaffected women.
Mothers with chronic disease initiate and continue some form of breastfeeding to six months as often as their unaffected peers. However, they have substantially higher odds of ceasing exclusive breastfeeding before the recommended 6 months. Findings suggest a need to investigate the reasons for this disparity to ensure that appropriate breastfeeding support is available for women with chronic disease and their children.
在过去的二十年中，孕妇慢性病的患病率一直在持续上升。大量证据表明，母体慢性病与早产等不良医疗结局有关，但对产后结局（如婴儿喂养方式）的研究较少。鉴于母乳喂养提供了众多健康益处，建议婴儿从出生到 6 个月完全母乳喂养。
确定母体慢性病与母乳喂养结局之间的关系。
我们分析了 2015/2016 年加拿大社区健康调查的横断面自我报告数据，仅限于在数据收集后 2 年内分娩的女性（n=2100，四舍五入）。暴露因素为专业诊断的慢性身体疾病（如糖尿病、关节炎、心脏病）。结局是母乳喂养未开始和在 6 个月前早期停止母乳喂养。使用多变量逻辑回归模型估计调整后的优势比（AOR）及其 95%置信区间（CI）。使用自举和加权方法对估计值进行估算，以代表全国人口。
总体而言，11.9%（95%CI 9.8-14.1）的女性报告患有慢性病，与无慢性病的女性相比，她们更有可能是单身、加拿大出生、受教育程度较低且超重/肥胖。两组女性的平均母亲年龄约为 30 岁。患有慢性病的女性母乳喂养未开始的可能性相似（AOR 0.96，95%CI 0.54-1.71）和任何形式的母乳喂养早期停止（AOR 1.40，95%CI 0.82-2.40），但与未受影响的女性相比，早期停止纯母乳喂养的可能性高出两倍多（AOR 2.48，95%CI 1.49-4.12）。
患有慢性病的母亲与未受影响的母亲一样，开始并持续母乳喂养至六个月。然而，她们在推荐的 6 个月前停止纯母乳喂养的可能性要大得多。研究结果表明，需要调查这种差异的原因，以确保为患有慢性病的妇女及其子女提供适当的母乳喂养支持。
