Hashemi-Nazari Seyed-Saeed, Hasani Jalil, Izadi Neda, Najafi Farid, Rahmani Jamal, Naseri Parisa, Rajabi Abdolhalim, Clark Cain
Prevention of Cardiovascular Disease Research Center, Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Torbat Jam Faculty of Medical Sciences, Torbat Jam, Iran.
Heliyon. 2020 Dec 7;6(12):e05622. doi: 10.1016/j.heliyon.2020.e05622. eCollection 2020 Dec.
Overweight and obesity not only are major risk factors for number of chronic diseases, but also a risk factor for pregnancy complications in women. The present study aims to investigate the association between pre-pregnancy BMI and the persistence and duration of BF. The electronic databases including Medline (PubMed), Scopus, Embase, Web of Science and Google Scholar were searched for papers with titles and/or abstracts including one of our keywords and published up to 15 April 2019. For dose-response relationship, the two-stage random-effects meta-analysis was performed using the "dosresmeta" function in R software. Thirty-two studies with the effect of pre-pregnancy BMI on BF initiation, intention and duration were included in the present study. Based on crude and adjusted OR models, the risk of BF cessation increased by 4% (OR = 1.04; 95% CI: 1.02-1.05) with an increase in a unit of BMI. In addition, based on crude and adjusted RR models, the risk of BF cessation increases by 2% and 1% (crude RR = 1.02; 95% CI: 1.01-1.03 and adjusted RR = 1.01; 95% CI: 0.99-1.02) with an increase in one unit of BMI. Based on the result, the health care professionals and other key stakeholders should be aware of the impact excess weight, and that women who are overweight or obese should be encouraged with continued access to guidance, counseling and support, starting from conception, to maximize BF outcomes.
超重和肥胖不仅是多种慢性疾病的主要危险因素，也是女性妊娠并发症的危险因素。本研究旨在调查孕前体重指数（BMI）与母乳喂养的持续时间和时长之间的关联。检索了包括Medline（PubMed）、Scopus、Embase、Web of Science和谷歌学术在内的电子数据库，查找标题和/或摘要中包含我们的关键词之一且截至2019年4月15日发表的论文。对于剂量反应关系，使用R软件中的“dosresmeta”函数进行两阶段随机效应荟萃分析。本研究纳入了32项关于孕前BMI对母乳喂养开始、意愿和持续时间影响的研究。基于粗略和调整后的比值比（OR）模型，BMI每增加一个单位，母乳喂养停止的风险增加4%（OR = 1.04；95%置信区间：1.02 - 1.05）。此外，基于粗略和调整后的风险比（RR）模型，BMI每增加一个单位，母乳喂养停止的风险分别增加2%和1%（粗略RR = 1.02；95%置信区间：1.01 - 1.03，调整后RR = 1.01；95%置信区间：0.99 - 1.02）。基于该结果，医疗保健专业人员和其他关键利益相关者应意识到超重的影响，并且应鼓励超重或肥胖的女性从怀孕开始就持续获得指导、咨询和支持，以最大化母乳喂养的效果。
