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台湾女性母乳喂养与产后体重滞留的剂量-反应关系因孕前体重指数而异。

Dose-Response Relationships between Breastfeeding and Postpartum Weight Retention Differ by Pre-Pregnancy Body-Mass Index in Taiwanese Women.

机构信息

Institute of Public Health, National Yang-Ming University, Taipei 112, Taiwan.

Tao Yuan General Hospital, Ministry of Health and Welfare, Taoyuan 320, Taiwan.

出版信息

Nutrients. 2020 Apr 11;12(4):1065. doi: 10.3390/nu12041065.

Abstract

Postpartum weight retention (PWR) is a risk factor for future obesity. The role of breastfeeding in reducing PWR is not fully understood. We examined the relationship between PWR and the duration of exclusive/partial breastfeeding in 52,367 postpartum women from 2012-2016 Taiwan national breastfeeding surveys. The women were interviewed at 7-14 months postpartum. Non-linear models were fit to examine the association between PWR and breastfeeding duration. PWR adjusted means and 95% confidence intervals were plotted and compared for the duration of exclusive/partial breastfeeding in the total sample and between pre-pregnancy body-mass index (BMI) groups (underweight, normal, overweight, and obese). Women who breastfed exclusively for >30 days showed significantly lower PWR than those who did not breastfeed and those who breastfed partially for the same duration, thereafter each additional duration of 30 days being associated with an average of 0.1-0.2 kg less PWR. Women who breastfed partially for 120 days showed lower PWR than those who did not or those who ceased to breastfeed, thereafter each additional duration of 30 days being associated with an average of 0.1 kg less PWR. Duration of breastfeeding needed to achieve significantly less PWR differed between pre-pregnancy BMI groups, but the effect of exclusive breastfeeding appeared earlier in the normal weight group. Women with obesity who breastfed exclusively for >30 or partially for >180 days, had lower PWR than non-obese groups. The observed dose-response relationship between breastfeeding duration and PWR supports the "every feeding matters" approach in breastfeeding promotion. The larger effect of exclusive and partial breastfeeding on PWR in women with obesity may draw special attention of breastfeeding promotion.

摘要

产后体重滞留(PWR)是未来肥胖的一个风险因素。母乳喂养在降低 PWR 方面的作用尚未完全明了。我们在 2012-2016 年对来自台湾全国母乳喂养调查的 52367 名产后妇女检查了 PWR 与纯母乳喂养/部分母乳喂养持续时间之间的关系。这些妇女在产后 7-14 个月接受了访谈。我们采用非线性模型来检验 PWR 与母乳喂养持续时间之间的关联。在总样本和孕前体重指数(BMI)组(体重不足、正常、超重和肥胖)中,我们绘制并比较了纯母乳喂养/部分母乳喂养持续时间的 PWR 调整均值和 95%置信区间。与不母乳喂养和同期部分母乳喂养的妇女相比,纯母乳喂养>30 天的妇女 PWR 显著降低,此后每增加 30 天,PWR 平均降低 0.1-0.2 公斤。部分母乳喂养 120 天的妇女 PWR 低于未母乳喂养或停止母乳喂养的妇女,此后每增加 30 天,PWR 平均降低 0.1 公斤。实现 PWR 显著降低所需的母乳喂养持续时间在孕前 BMI 组之间存在差异,但在正常体重组中,纯母乳喂养的作用出现得更早。纯母乳喂养>30 天或部分母乳喂养>180 天的肥胖妇女 PWR 低于非肥胖组。母乳喂养持续时间与 PWR 之间观察到的剂量-反应关系支持在母乳喂养促进中采用“每次喂养都重要”的方法。母乳喂养对肥胖妇女 PWR 的影响大于纯母乳喂养和部分母乳喂养,这可能需要特别关注母乳喂养的促进。

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