University Department of Gynecology and Obstetrics, Hospital St. Hedwig of the Order of St. John, University Medical Center Regensburg, Steinmetzstr., 1-3, 93049, Regensburg, Germany.
University Children's Hospital Regensburg (KUNO), Hospital St. Hedwig of the Order of St. John, University of Regensburg, Steinmetzstr., 1-3, 93049, Regensburg, Germany.
Arch Gynecol Obstet. 2021 Nov;304(5):1161-1168. doi: 10.1007/s00404-021-06038-2. Epub 2021 Apr 27.
Despite the health benefits of full breastfeeding for both infants and mothers, less than 50% of mothers in Germany practice this method for at least 4 months after childbirth. Because of the growing importance of health literacy to improve public health, we investigated the role of maternal health literacy in breastfeeding behavior.
We analyzed the data of 1172 mother-child dyads of the KUNO-Kids health study of the University Children's and Maternity Hospital Regensburg. Maternal health literacy was assessed with the HLS-EU-Q47 questionnaire (sub-index health care) up to 48 h after childbirth. Outcome was analyzed 6 months after childbirth and categorized into full breastfeeding for less than 4 months or for at least 4 months. The association between breastfeeding and maternal health literacy was calculated with univariable and multivariable logistic regression analyses.
38.8% of mothers showed inadequate or limited health literacy. 75.9% of mothers had fully breastfed their child for at least 4 months. Univariable logistic regression analysis showed that health literacy and full breastfeeding for at least 4 months were not associated (OR = 0.995 [CI 0.977-1.015], p = 0.60). After adjusting for all potentially confounding variables with a significant association (p ≤ 0.05) on both health literacy and breastfeeding, the multivariable model showed no association between health literacy and breastfeeding (OR = 0.984 [CI 0.963-1.007], p = 0.170).
Surprisingly, we found no association between health literacy and breastfeeding behavior in our study. Therefore, future research with comparable measurements of health literacy and breastfeeding is required to validate this result and to identify reasons for early breastfeeding cessation.
尽管完全母乳喂养对婴儿和母亲都有健康益处，但德国只有不到 50%的母亲在产后至少 4 个月内采用这种方法。由于健康素养对改善公共健康的重要性日益增加，我们研究了产妇健康素养在母乳喂养行为中的作用。
我们分析了雷根斯堡大学儿童医院 KUNO-Kids 健康研究的 1172 对母婴对子的数据。在产后 48 小时内，使用 HLS-EU-Q47 问卷（健康护理子指数）评估产妇健康素养。将产后 6 个月的结果进行分析，并分为完全母乳喂养少于 4 个月或至少 4 个月。使用单变量和多变量逻辑回归分析计算母乳喂养与产妇健康素养之间的关联。
38.8%的母亲表现出不足或有限的健康素养。75.9%的母亲至少 4 个月完全母乳喂养孩子。单变量逻辑回归分析显示，健康素养与至少 4 个月的完全母乳喂养之间无关联（OR=0.995[CI 0.977-1.015]，p=0.60）。在调整所有与健康素养和母乳喂养均有显著关联的潜在混杂变量后（p≤0.05），多变量模型显示健康素养与母乳喂养之间无关联（OR=0.984[CI 0.963-1.007]，p=0.170）。
令人惊讶的是，我们在研究中没有发现健康素养与母乳喂养行为之间的关联。因此，需要进行具有可比性的健康素养和母乳喂养测量的未来研究来验证这一结果，并确定早期母乳喂养中断的原因。
