2 岁前母乳喂养中断的风险因素和保护因素：一项出生队列研究。

Risk factors for and protective factors against breastfeeding interruption before 2 years: a birth cohort study.

机构信息

Universidade Estadual de Feira de Santana, Feira de Santana, BA, Brazil.

Universidade Federal do Recôncavo da Bahia, Santo Antônio de Jesus, BA, Brazil.

出版信息

BMC Pediatr. 2021 Jul 9;21(1):310. doi: 10.1186/s12887-021-02777-y.

DOI:10.1186/s12887-021-02777-y

PMID:34243743

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8268268/

Abstract

BACKGROUND

Little is known about the factors associated with the World Health Organization (WHO) recommendation of breastfeeding for at least 2 years. The objective of this study was to identify risk factors for and protective factors against breastfeeding interruption before 2 years of age.

METHODS

In this live birth cohort, mother and infant dyads were followed for 2 years. Data collection was performed at the maternity ward and subsequently at the children's homes, monthly during the first 6 months of life and then at 9, 12, 18, and 24 months. The outcome of interest was breastfeeding interruption before 2 years of age. Median duration of breastfeeding was estimated using Kaplan-Meier's survival analysis, and the associations were tested using Cox's hierarchical multivariate model. Significance was set at 5%.

RESULTS

Data from a total of 1344 dyads were assessed. Median breastfeeding duration was 385 days. The following risk factors for breastfeeding interruption were identified: white skin color (adjusted hazard ratio [HRa]: 1.31; 95% confidence interval [95%CI]: 1.10-1.56), primiparity (HRa: 1.21; 95%CI: 1.05-1.40), working outside the home (HRa: 1.52; 95%CI: 1.30-1.77), child sex male (HRa: 1.18; 95%CI: 1.03-1.35) and use of a pacifier (HRa: 3.46; 95%CI: 2.98-4.01). Conversely, the following protective factors were identified: lower family income (HRa: 0.81; 95%CI: 0.71-0.94), mother-infant bed-sharing (HRa:0.61, 95%CI: 0.52-0.73), on-demand breastfeeding in the first month (HRa: 0.64; 95%CI: 0.47-0.89) and exclusive breastfeeding at 4 months (HRa: 0.58, 95%CI: 0.48-0.70).

CONCLUSIONS

The findings allowed to identify both risk factors for and protective factors against breastfeeding interruption before 2 years of age. Knowledge of these factors may help prevent this event and aid in the development of programs that help women maintain breastfeeding for at least 2 years, as recommended by the WHO.

摘要

背景

关于世界卫生组织（WHO）建议至少母乳喂养 2 年相关因素的了解甚少。本研究的目的是确定 2 岁前母乳喂养中断的风险因素和保护因素。

方法

在这项活产队列研究中，对母婴对进行了 2 年的随访。数据收集在产科病房进行，随后在儿童之家进行，在生命的头 6 个月每月进行一次，然后在 9、12、18 和 24 个月进行。感兴趣的结果是 2 岁前母乳喂养中断。使用 Kaplan-Meier 生存分析估计中位母乳喂养持续时间，并使用 Cox 分层多变量模型检验关联。设 5%为显著性水平。

结果

共评估了 1344 对母婴对的数据。中位母乳喂养持续时间为 385 天。母乳喂养中断的以下风险因素包括：皮肤白皙（调整后的危险比 [HRa]：1.31；95%置信区间 [95%CI]：1.10-1.56）、初产（HRa：1.21；95%CI：1.05-1.40）、外出工作（HRa：1.52；95%CI：1.30-1.77）、儿童性别为男（HRa：1.18；95%CI：1.03-1.35）和使用奶嘴（HRa：3.46；95%CI：2.98-4.01）。相反，以下保护因素包括：家庭收入较低（HRa：0.81；95%CI：0.71-0.94）、母婴同床（HRa：0.61，95%CI：0.52-0.73）、第一个月按需母乳喂养（HRa：0.64；95%CI：0.47-0.89）和 4 个月时纯母乳喂养（HRa：0.58，95%CI：0.48-0.70）。