母亲对母乳喂养的满意度与产后抑郁症状之间的关系。
Association between maternal satisfaction with breastfeeding and postpartum depression symptoms.
机构信息
Graduate Program in Child and Adolescent Health, Faculty of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil.
Graduate Program in Epidemiology, Faculty of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil.
出版信息
PLoS One. 2020 Nov 17;15(11):e0242333. doi: 10.1371/journal.pone.0242333. eCollection 2020.
BACKGROUND
Due to the multiple health benefits of breastfeeding, it is essential to identify factors that may negatively interfere with this healthy practice. Among such factors are postpartum depression (PPD) and maternal satisfaction with breastfeeding. The objective of this study was to evaluate the association between maternal satisfaction with breastfeeding and symptoms of PPD in the first month after childbirth.
METHODS
This cross-sectional study nested in a cohort study was conducted in Porto Alegre, Brazil, with 287 puerperal women selected at two maternity hospitals, one public and one private. Women were interviewed at their homes the week after the infant completed 30 days of life. A structured questionnaire was applied, as well as instruments to evaluate maternal satisfaction with breastfeeding (Maternal Breastfeeding Evaluation Scale) and to screen for PPD (Edinburgh Postnatal Depression Scale). The association between higher satisfaction with breastfeeding (outcome) and negative PPD screening test was assessed using Poisson regression with robust variance, adjusting for specific covariables. Adjusted prevalence ratios (aPR) and respective 95% confidence intervals (95%CI) were estimated.
RESULTS
The prevalence of increased satisfaction with breastfeeding (defined as women with scores above the median) was 47% higher among women who screened negative for PPD when compared to those with a positive result (aPR 1.47; 95%CI 1.01-2.16). This result was adjusted for maternal age and skin color, cohabitation with the infant's father, planned pregnancy, type of delivery, exclusive breastfeeding, and occurrence of breastfeeding problems.
CONCLUSIONS
The findings of this study showed an association between higher maternal satisfaction with breastfeeding and absence of PPD symptoms, reinforcing the importance of caring for the mental health of pregnant and puerperal women and paying attention to their satisfaction with breastfeeding.
背景
由于母乳喂养对健康有多种益处，因此确定可能对这一健康行为产生负面影响的因素至关重要。这些因素包括产后抑郁（PPD）和产妇对母乳喂养的满意度。本研究的目的是评估产妇对母乳喂养的满意度与产后第一个月 PPD 症状之间的关联。
方法
这是一项在巴西阿雷格里港进行的横断面研究，嵌套在队列研究中，共有 287 名产妇在两家妇产医院（一家公立医院和一家私立医院）中选择。在婴儿满 30 天时，在家中对女性进行访谈。应用了结构式问卷以及评估产妇对母乳喂养满意度的工具（母乳喂养母亲评价量表）和筛查 PPD 的工具（爱丁堡产后抑郁量表）。使用稳健方差的 Poisson 回归评估较高的母乳喂养满意度（结局）与 PPD 筛查试验呈阴性之间的关联，并调整了特定协变量。估计了调整后的患病率比（aPR）和相应的 95%置信区间（95%CI）。
结果
与筛查阳性的女性相比，PPD 筛查阴性的女性对母乳喂养的满意度增加（定义为评分高于中位数）的可能性高 47%（aPR 1.47；95%CI 1.01-2.16）。该结果调整了产妇的年龄和肤色、与婴儿父亲的同居情况、计划妊娠、分娩方式、纯母乳喂养和发生母乳喂养问题。
结论
本研究结果表明，产妇对母乳喂养的满意度较高与 PPD 症状不存在之间存在关联，这强调了关注孕妇和产妇的心理健康以及关注她们对母乳喂养的满意度的重要性。
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