Department of Prevention and Community Health and Milken Institute School of Public Health, George Washington University, Washington, District of Columbia, USA.
Department of Global Health, Milken Institute School of Public Health, George Washington University, Washington, District of Columbia, USA.
Breastfeed Med. 2021 Nov;16(11):878-885. doi: 10.1089/bfm.2021.0136. Epub 2021 Sep 24.
To assess associations between smoking behaviors during pregnancy and postpartum and breastfeeding initiation and duration, among DC Women, Infants, and Children (WIC) recipients, the majority of whom are non-White, controlling for sociodemographic factors, low birth weight (LBW), and delivery in a Baby-Friendly hospital (BFH). A series of ordinary least squares and logistic regressions estimated the association between smoking during pregnancy and postpartum on breastfeeding initiation and duration, respectively. A multilevel modeling approach accounted for WIC site effects. Overall, 8.8% of DC WIC recipients smoked during pregnancy. Smoking during pregnancy and postpartum was negatively associated with breastfeeding initiation (adjusted odds ratio [aOR] = 0.47, 95% confidence interval [CI]: 0.36, 0.61) and duration (adjusted coefficient [] = -37.96, 95% CI: -62.92, -13.00) in adjusted models, respectively. Maternal age, race, marital status, LBW, and delivery in a BFH were also significantly associated with initiation, while age, race, and marital status were significantly associated with duration. Likewise, the number of cigarettes smoked per day was negatively associated with initiation (aOR = 0.79, 95% CI: 0.72, 0.87) and duration ( = -8.98, 95% CI: -15.55, -2.41) in adjusted models. Both smoking and number of cigarettes smoked during pregnancy and postpartum are significant factors associated with less breastfeeding in the DC WIC population. Furthermore, smoking cessation during pregnancy shows initial promise to increase breastfeeding initiation. Future research is needed to better understand the role of smoking, relapse, and cessation interventions on breastfeeding rates among low-income, predominantly minority populations.
为了评估在哥伦比亚特区母婴健康计划（WIC）参与者中，吸烟行为与母乳喂养的开始和持续时间之间的关联，这些参与者大多数是非裔美国人，控制了社会人口因素、低出生体重（LBW）和在婴儿友好医院（BFH）分娩。使用普通最小二乘法和逻辑回归分别估计了怀孕期间和产后吸烟与母乳喂养开始和持续时间之间的关联。使用多层次建模方法考虑了 WIC 站点的影响。总的来说，8.8%的哥伦比亚特区 WIC 参与者在怀孕期间吸烟。怀孕期间和产后吸烟与母乳喂养的开始（调整后的优势比[aOR] = 0.47，95%置信区间[CI]：0.36，0.61）和持续时间（调整后的系数[] = -37.96，95%CI：-62.92，-13.00）均呈负相关，在调整后的模型中。母亲年龄、种族、婚姻状况、LBW 和在 BFH 分娩也与开始显著相关，而年龄、种族和婚姻状况与持续时间显著相关。同样，每天吸烟的数量与开始（aOR = 0.79，95%CI：0.72，0.87）和持续时间（ = -8.98，95%CI：-15.55，-2.41）呈负相关，在调整后的模型中。怀孕期间和产后吸烟的数量都是与哥伦比亚特区 WIC 人群中母乳喂养减少相关的重要因素。此外，怀孕期间戒烟似乎可以提高母乳喂养的开始率。需要进一步的研究来更好地理解吸烟、复吸和戒烟干预措施在低收入、以少数族裔为主的人群中的母乳喂养率的作用。
