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与巴西医院婴儿配方奶粉补充相关的因素:一项横断面研究。

Factors associated with infant formula supplementation in Brazilian hospitals: a cross-sectional study.

机构信息

Fundação Oswaldo Cruz, Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira, Programa de Pós-Graduação em Saúde da Criança e da Mulher, Rio de Janeiro, RJ, Brazil.

Universidade Federal Fluminense, Instituto de Saúde Coletiva, Departamento de Epidemiologia e Bioestatística, Niterói, RJ, Brazil.

出版信息

J Pediatr (Rio J). 2022 Sep-Oct;98(5):463-470. doi: 10.1016/j.jped.2021.12.009. Epub 2022 Feb 25.

Abstract

OBJECTIVE

To analyze the factors associated with infant formula supplementation in newborns referred to rooming-in in Brazilian hospitals.

METHOD

Cross-sectional study with data from 14,531 postpartum women and newborns obtained from the "Birth in Brazil" survey, conducted in 2011-2012. The analysis used a logistic regression model with a hierarchical approach.

RESULTS

In total, 21.2% newborns received infant formula during hospital stay. After adjustment, the following factors were associated with the use of infant formula: maternal age ≥ 35 years (OR = 1.51; IC95%:1.30-1.75), prenatal care in a private service (OR = 2,22; IC:1.72-2.85)/public and private service (OR = 1.67; IC:1.24-2.23), cesarean delivery (OR = 1.83; IC:1.41-2.38), multiple pregnancy (OR = 3.786; IC:2.02-7.06), non-breastfeeding in the delivery room (OR = 1.780; IC:1.43-2.21), birth in a private hospital (OR = 1.695; IC:1.02-2.79), prematurity (OR = 1.656; IC:1.32-2.06) and extremes of birth weight (< 2.500 g: OR = 2.084; IC: 1.585-2.741/ ≥4,000g: OR = 1.672; IC:1.31-2.11). Teenage age (OR = 0.651; IC:0.55-0.76), low maternal education (OR = 0.579; IC:0.43-0.77), multiparity (OR = 0.588; IC:0.510-0.678), and lower economic class (OR = 0.565; IC:0.41-0.76) significantly reduced the probability of using infant formula.

CONCLUSIONS

Of the associated factors, the authors highlight cesarean delivery and non-breastfeeding in the delivery room, showing that it is necessary to strengthen policies that encourage good practices during childbirth care in order to promote exclusive breastfeeding and protect mothers and newborns from all social classes against the misuse of infant formula.

摘要

目的

分析与巴西医院母婴同室新生儿配方奶补充相关的因素。

方法

横断面研究,数据来自于 2011-2012 年“巴西生育”调查中的 14531 名产后妇女及其新生儿。采用分层逻辑回归模型进行分析。

结果

共有 21.2%的新生儿在住院期间接受了配方奶。调整后,以下因素与使用配方奶有关:母亲年龄≥35 岁(OR=1.51;95%CI:1.30-1.75)、在私立服务机构(OR=2.22;95%CI:1.72-2.85)/公私混合服务机构(OR=1.67;95%CI:1.24-2.23)接受产前护理、剖宫产(OR=1.83;95%CI:1.41-2.38)、多胎妊娠(OR=3.786;95%CI:2.02-7.06)、分娩时非母乳喂养(OR=1.780;95%CI:1.43-2.21)、在私立医院分娩(OR=1.695;95%CI:1.02-2.79)、早产(OR=1.656;95%CI:1.32-2.06)和出生体重极低(OR=2.084;95%CI:1.585-2.741/≥4000g:OR=1.672;95%CI:1.31-2.11)和极高(OR=1.672;95%CI:1.31-2.11)。未成年母亲(OR=0.651;95%CI:0.55-0.76)、母亲受教育程度低(OR=0.579;95%CI:0.43-0.77)、多产(OR=0.588;95%CI:0.510-0.678)和较低的经济阶层(OR=0.565;95%CI:0.41-0.76)显著降低了使用配方奶的可能性。

结论

在相关因素中,作者强调了剖宫产和分娩时非母乳喂养,这表明有必要加强政策,鼓励在分娩护理中实施良好做法,以促进纯母乳喂养,并保护母亲和新生儿免受各种社会阶层对配方奶的滥用。

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