Pylypjuk Christy, Bokhanchuk Anna, Day Chelsea, ElSalakawy Yasmine, Seshia Mary M
Department of Obstetrics, Gynecology & Reproductive Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.
Children's Hospital Research Institute of Manitoba, University of Manitoba, Winnipeg, Manitoba, Canada.
Eur J Obstet Gynecol Reprod Biol X. 2022 Jul 7;15:100160. doi: 10.1016/j.eurox.2022.100160. eCollection 2022 Aug.
To determine the prevalence and factors associated with antenatal promotion of breastfeeding in high-risk pregnancies.
This was a cross-sectional study of trends in breastfeeding promotion during antenatal consultation of pregnancies at high-risk for newborn admission to the neonatal intensive care unit (NICU) between January 2017 and December 2020. Eligible high-risk pregnant patients undergoing antenatal consultation in a tertiary-level fetal assessment unit were identified using an electronic clinic repository. Consult letters and fetal assessment reports were reviewed to determine baseline demographics, pregnancy history, fetal findings, and communication about breastfeeding. Descriptive and inferential statistics were used to present findings and compare outcomes between groups.
316 pregnancies were included for final analysis. The mean maternal age was 28.7 years (SD 6.2) and 65 % were multiparas. Median gestational age at time of antenatal consult was 32 weeks [IQR 29-34]. The main indication for consultation was fetal anomalies (72.8%), namely cardiac defects (21.2 %). There was a significant improvement in prevalence of antenatal discussions about breastfeeding over the study period, from 48.8 % early in the study period compared to 73.7 % in the past year (p = 0.036). However, amongst consults where breastfeeding was discussed, almost one-quarter (23.8 %) of patients indicated that they were not planning on breastfeeding postnatally.
There has been a significant improvement in promoting breastfeeding antenatally amongst high-risk pregnancies. However, no follow-up or supports were offered to one-quarter of patients who indicated no intention of breastfeeding or using donor milk postnatally. Ongoing work is required to further advance breastfeeding promotion antenatally, increase parental supports and education, and optimize breastfeeding rates postnatally for improving outcomes of this high-risk group.
确定高危妊娠中产前促进母乳喂养的患病率及相关因素。
这是一项横断面研究，旨在探讨2017年1月至2020年12月期间，新生儿需入住新生儿重症监护病房（NICU）的高危妊娠产前咨询中母乳喂养促进的趋势。通过电子门诊资料库识别在三级胎儿评估单位接受产前咨询的符合条件的高危孕妇。查阅咨询信件和胎儿评估报告，以确定基线人口统计学特征、妊娠史、胎儿检查结果以及关于母乳喂养的沟通情况。使用描述性和推断性统计方法呈现研究结果并比较组间结局。
最终纳入分析的妊娠有316例。产妇平均年龄为28.7岁（标准差6.2），65%为经产妇。产前咨询时的中位孕周为32周[四分位间距29 - 34]。咨询的主要指征是胎儿异常（72.8%），即心脏缺陷（21.2%）。在研究期间，产前关于母乳喂养讨论的患病率有显著提高，研究初期为48.8%，而过去一年为73.7%（p = 0.036）。然而，在讨论了母乳喂养的咨询中，近四分之一（23.8%）的患者表示产后不打算母乳喂养。
高危妊娠产前促进母乳喂养方面有显著改善。然而，四分之一表示产后无意母乳喂养或使用捐赠母乳的患者未得到后续跟进或支持。需要持续开展工作，以进一步推进产前母乳喂养促进，增加家长支持和教育，并优化产后母乳喂养率，以改善这一高危群体的结局。
