WellSpan Health, Women and Children Service Line, 1001 S. George St, York, PA, 17405, USA.
Neonatal Intensive Care Unit, Studer Family Children's Hospital, 1 Bubba Watson Drive, Pensacola, FL, 32504, USA.
Matern Child Health J. 2021 Apr;25(4):666-675. doi: 10.1007/s10995-020-03069-0. Epub 2020 Nov 16.
Hypertensive disorders of pregnancy have lifelong implications on maternal cardiovascular health. Breastfeeding has a variety of maternal benefits, including improved lifelong maternal cardiovascular outcomes, with longer periods of lactation resulting in further improvement. Women with hypertensive disorders of pregnancy encounter many barriers to breastfeeding. Little is known about lactation initiation and duration rates in women with hypertensive disorders of pregnancy. The purpose of this study is to describe lactation patterns in women with HDP, hypertensive disorders of pregnancy, compared to normotensive controls using data from the phase 7 Illinois Pregnancy Risk Assessment Monitoring System (PRAMS).
Illinois PRAMS 2012-2015 (Phase 7) data was used to assess lactation patterns as well as rationale for not initiating breastfeeding or earlier cessation. Women who delivered during this time period were eligible to participate in the PRAMS survey, 5285 were included the analysis.
Overall, 17.6% of all women in the study reported their healthcare provider did not speak with them prenatally about breastfeeding. Women who reported they had HDP, were significantly less likely (p ≤ 0.001) to ever breastfeed or pump breast milk to feed their baby, even for a short period, than those women without an HDP. At the time the PRAMS survey was completed, more women without an HDP were still breastfeeding or providing their baby with pumped milk (54.9 v. 48%; p = 0.002). More women with HDP reported stopping breastfeeding because they got sick or had to stop for medical reasons (p = 0.002) and/or because their baby was jaundiced (p = 0.007).
Cardiovascular disease remains the leading cause of death among women and women with a history of HDP are at increased risk for cardiovascular related morbidity and mortality. Obstetrical providers and nurses caring for this high-risk population should ensure they educate women about the increased cardiovascular risk associated with HDP and the maternal cardiovascular benefits associated with lactation in order to promote and support lactation in this population of women.
妊娠高血压疾病对产妇心血管健康有终身影响。母乳喂养对产妇有多种益处，包括改善产妇的心血管结局，母乳喂养时间越长，效果越好。患有妊娠高血压疾病的妇女在母乳喂养方面会遇到很多障碍。关于患有妊娠高血压疾病的妇女的母乳喂养起始率和持续时间率知之甚少。本研究的目的是使用伊利诺伊州妊娠风险评估监测系统（PRAMS）第 7 阶段的资料，描述患有妊娠高血压疾病的妇女与血压正常的对照组妇女的母乳喂养模式。
使用伊利诺伊州 PRAMS 2012-2015 年（第 7 阶段）的数据评估母乳喂养模式以及不开始母乳喂养或提前停止母乳喂养的原因。在此期间分娩的妇女有资格参加 PRAMS 调查，共有 5285 名妇女参与了分析。
总体而言，研究中 17.6%的妇女报告其医疗保健提供者在产前没有与她们讨论过母乳喂养的问题。报告患有妊娠高血压疾病的妇女，与没有妊娠高血压疾病的妇女相比，从未进行过母乳喂养或泵奶喂养婴儿（即使是短时间）的可能性显著降低（p≤0.001）。在完成 PRAMS 调查时，更多没有妊娠高血压疾病的妇女仍在母乳喂养或提供泵奶喂养婴儿（54.9%对 48%；p=0.002）。更多患有妊娠高血压疾病的妇女报告因生病或因医疗原因而停止母乳喂养（p=0.002）和/或因婴儿黄疸（p=0.007）而停止母乳喂养。
心血管疾病仍然是女性死亡的主要原因，有妊娠高血压疾病史的女性患心血管相关发病率和死亡率的风险增加。照顾这一高危人群的产科医生和护士应确保向妇女宣传与妊娠高血压疾病相关的心血管风险增加以及母乳喂养对产妇心血管的益处，以促进和支持这一人群的母乳喂养。
