Watson Carey, Wei Julia, Varnado Nicole, Rios Normelena, Flanagan Tracy, Alabaster Amy, Staunton Mary, Sterling Stacy A, Gunderson Erica P, Young-Wolff Kelly C
Obstetrics and Gynecology, Kaiser Antioch Medical Center, Antioch, California, USA.
Division of Research, Kaiser Permanente Northern California, Oakland, California, USA.
J Womens Health (Larchmt). 2021 Mar;30(3):367-376. doi: 10.1089/jwh.2020.8697. Epub 2021 Feb 4.
To examine whether adverse childhood experiences (ACEs) are associated with breastfeeding behaviors. Women in three Kaiser Permanente Northern California medical centers were screened for ACEs during standard prenatal care ( = 926). Multivariable binary and multinomial logistic regression was used to test whether ACEs (count and type) were associated with early breastfeeding at the 2-week newborn pediatric visit and continued breastfeeding at the 2-month pediatric visit, adjusting for covariates. Overall, 58.2% of women reported 0 ACEs, 19.2% reported 1 ACE, and 22.6% reported 2+ ACEs. Two weeks postpartum, 92.2% reported any breastfeeding (62.9% exclusive, 29.4% mixed breastfeeding/formula). Compared with women with 0 ACEs, those with 2+ ACEs had increased odds of any breastfeeding (odds ratio [OR] = 2.7, 95% confidence interval [CI] = 1.3-5.6) and exclusive breastfeeding 2 weeks postpartum (OR = 3.0, 95% CI = 1.4-6.3). Among those who breastfed 2 weeks postpartum, 86.4% reported continued breastfeeding (57.5% exclusive, 28.9% mixed breastfeeding/formula) 2 months postpartum. ACE count was not associated with continued breastfeeding 2 months postpartum. Individual ACEs were not related to breastfeeding outcomes, with the exception that living with someone who went to jail or prison was associated with lower odds of continued breastfeeding 2 months postpartum. ACE count was associated with greater early breastfeeding, but not continued breastfeeding, among women screened for ACEs as part of standard prenatal care. Results reiterate the need to educate and assist all women to meet their breastfeeding goals, regardless of ACE score.
为了研究童年不良经历（ACEs）是否与母乳喂养行为相关。在加利福尼亚州北部的三家凯撒医疗中心，对参与标准产前护理的女性进行了ACEs筛查（n = 926）。采用多变量二元和多项逻辑回归分析，在调整协变量的情况下，检验ACEs（数量和类型）是否与新生儿2周儿科就诊时的早期母乳喂养以及2个月儿科就诊时的持续母乳喂养相关。总体而言，58.2%的女性报告有0次ACEs，19.2%报告有1次ACEs，22.6%报告有2次及以上ACEs。产后两周，92.2%的女性报告进行了母乳喂养（62.9%为纯母乳喂养，29.4%为混合喂养/配方奶喂养）。与有0次ACEs的女性相比，有2次及以上ACEs的女性进行任何形式母乳喂养的几率增加（优势比[OR]=2.7，95%置信区间[CI]=1.3 - 5.6），产后两周纯母乳喂养的几率增加（OR = 3.0，95% CI = 1.4 - 6.3）。在产后两周进行母乳喂养的女性中，86.4%报告在产后2个月持续进行母乳喂养（57.5%为纯母乳喂养，28.9%为混合喂养/配方奶喂养）。ACEs数量与产后2个月的持续母乳喂养无关。除了与曾入狱或服刑的人一起生活与产后2个月持续母乳喂养的几率较低相关外，个体ACEs与母乳喂养结果无关。在作为标准产前护理一部分接受ACEs筛查的女性中，ACEs数量与早期母乳喂养增加有关，但与持续母乳喂养无关。结果再次强调，无论ACEs评分如何，都需要对所有女性进行教育和帮助，以实现她们的母乳喂养目标。
