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孟加拉国与产后母乳喂养起始延迟相关的母婴围产期因素:二次分析。

Maternal and neonatal peripartum factors associated with late initiation of breast feeding in Bangladesh: a secondary analysis.

机构信息

Centre for Non-communicable Diseases and Nutrition, BRAC James P Grant School of Public Health, BRAC University, Dhaka, Dhaka District, Bangladesh.

Department of Nutrition, University of California Davis, Davis, California, USA.

出版信息

BMJ Open. 2022 May 18;12(5):e051004. doi: 10.1136/bmjopen-2021-051004.

Abstract

OBJECTIVES

Late initiation of breast feeding (LIBF) is associated with increased neonatal mortality and morbidity. This study aimed to assess the association between intrapartum, early postpartum and neonatal factors, and LIBF in Bangladesh.

DESIGN, SETTING AND PARTICIPANTS: In this analysis, we used data from the mothers participating in a cluster-randomised controlled trial (Rang-Din Nutrition Study) conducted in rural northwest Bangladesh. Mothers (n=3594) were interviewed about the time of initiation of breast feeding, and peripartum maternal and neonatal complications within the first 72 hours of delivery. LIBF was defined as initiation of breast feeding 1 hour after birth. Factors associated with LIBF were identified by multivariable logistic regression analysis.

MAIN OUTCOME MEASURES

Prevalence and associated factors of LIBF.

RESULTS

The prevalence of LIBF was 18.5%. Factors significantly associated with LIBF in multivariable logistic regression were assisted vaginal delivery (adjusted OR (AOR) 2.17, 95% CI 1.44 to 3.27); delivery by caesarean section (AOR 9.67, 95% CI 7.21 to 12.96); maternal health problems during childbirth (AOR 1.61, 95% CI 1.30 to 2.00); preterm newborns (AOR 1.39, 95% CI 1.09 to 1.78); newborns moved slowly immediately after birth (AOR 1.43, 95% CI 1.05 to 1.94); and sick newborns (AOR 1.60, 95% CI 1.12 to 2.29).

CONCLUSIONS

Findings from this study suggest that to reduce LIBF, peripartum maternal and neonatal complications should be prevented and treated.

TRIAL REGISTRATION NUMBER

NCT01715038.

摘要

目的

晚启动母乳喂养(LIBF)与新生儿死亡率和发病率增加有关。本研究旨在评估孟加拉国分娩期间、产后早期和新生儿因素与 LIBF 之间的关系。

设计、地点和参与者:在这项分析中,我们使用了来自参与孟加拉国西北部农村地区进行的一项集群随机对照试验(Rang-Din 营养研究)的母亲的数据。母亲(n=3594)接受了关于母乳喂养开始时间的访谈,并在分娩后 72 小时内报告了围产期母婴并发症。LIBF 被定义为出生后 1 小时开始母乳喂养。通过多变量逻辑回归分析确定与 LIBF 相关的因素。

主要结果测量

LIBF 的流行率和相关因素。

结果

LIBF 的流行率为 18.5%。多变量逻辑回归分析中与 LIBF 显著相关的因素是阴道助产(调整后的比值比(AOR)2.17,95%置信区间 1.44 至 3.27);剖宫产(AOR 9.67,95%置信区间 7.21 至 12.96);分娩期间母亲健康问题(AOR 1.61,95%置信区间 1.30 至 2.00);早产儿(AOR 1.39,95%置信区间 1.09 至 1.78);新生儿出生后立即行动缓慢(AOR 1.43,95%置信区间 1.05 至 1.94);和生病的新生儿(AOR 1.60,95%置信区间 1.12 至 2.29)。

结论

本研究结果表明,为了降低 LIBF,应预防和治疗围产期母婴并发症。

试验注册

NCT01715038。

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