Department of Nutritional Sciences, The University of Texas at Austin, 200 W. 24th Street, A2703, Austin, United States.
Steve Hicks School of Social Work, The University of Texas at Austin, 1925 San Jacinto Blvd, Austin, United States.
Int Breastfeed J. 2023 Jan 5;18(1):1. doi: 10.1186/s13006-022-00534-0.
Almost half of all pregnant women in the United States gain weight above Institute of Medicine gestational weight gain guidelines. Breastfeeding has been shown to reduce weight retention in the first year postpartum; however, women with lower socioeconomic status (SES) tend to initiate breastfeeding less often than women with higher SES. We investigated associations between duration of breastfeeding with mother's long-term postpartum weight status at 4-10 years and evaluated whether the associations varied by SES.
Maternal and infant dyads (N = 2144 dyads) are from the Geographic Research on Wellbeing survey (GROW), 2012-2013, a long-term, cross-sectional follow-up of the Maternal and Infant Health Assessment (MIHA) based in California, USA. Pre-pregnancy body mass index (BMI) was obtained from self-report of height and weight during MIHA, while breastfeeding history and self-report of current body weight was collected at the 4-10 year GROW postpartum visit. SES score was derived from a composite score of percent federal poverty level and education and was dichotomized into High and Low SES groups at a score of three. Multivariable linear regression was used to examine association between breastfeeding and maternal weight status, and to examine for effect modification by SES.
Average long-term weight retention 4-10 years postpartum was 4.0 kg. Fewer lower SES vs. higher SES women breast fed at least six months (51% versus 70%, p < .001) or ever breastfed (74% versus 89%, P < .001). Women who breastfed at least six months had lower long-term postpartum weight retention compared to those who did not (b = -1.06 kg, (-1.93, 0.25); p = 0.01); however, these association did not vary by SES.
Six months of breastfeeding is associated with lower BMI at 4-10 years and lower body weight, and effects do not vary by SES. Future policies and guidelines should consider building an infrastructure that is supportive of longer breastfeeding duration. Moreover, further research is needed to identify the impact of additional behavioral and environmental factors on long-term maternal weight status. Understanding the drivers of excessive weight retention pospartum can help us not only improve the pregnant person's health but the health of their children.
在美国，几乎一半的孕妇体重增加超过了医学研究所的妊娠体重增加指南。母乳喂养已被证明可以减少产后第一年的体重滞留；然而，社会经济地位较低的女性往往比社会经济地位较高的女性更不愿意开始母乳喂养。我们研究了母乳喂养时间与母亲产后 4-10 年长期体重状况之间的关联，并评估了这些关联是否因社会经济地位而异。
母婴对子（N=2144 对子）来自地理福祉研究（GROW），这是对美国加利福尼亚州母婴健康评估（MIHA）的长期、横断面随访。母亲在 MIHA 期间通过自我报告身高和体重获得孕前体重指数（BMI），而在 GROW 产后 4-10 年的随访中，通过自我报告母乳喂养史和当前体重获得母乳喂养情况。社会经济地位评分是通过联邦贫困水平和教育百分比的综合评分得出的，并在评分为三时分为高和低社会经济地位两组。多变量线性回归用于检查母乳喂养与母亲体重状况之间的关联，并检查社会经济地位的调节作用。
产后 4-10 年的平均长期体重滞留为 4.0 公斤。与社会经济地位较高的女性相比，社会经济地位较低的女性母乳喂养至少 6 个月（51%对 70%，p<0.001）或母乳喂养过（74%对 89%，p<0.001）的比例较低。与从未母乳喂养的女性相比，至少母乳喂养 6 个月的女性产后长期体重滞留较低（b=-1.06kg，（-1.93，0.25）；p=0.01）；然而，这些关联在社会经济地位方面没有差异。
母乳喂养至少 6 个月与产后 4-10 年时的 BMI 较低和体重较低有关，且效果不因社会经济地位而异。未来的政策和指导方针应考虑建立一个支持更长母乳喂养时间的基础设施。此外，还需要进一步研究确定其他行为和环境因素对长期产妇体重状况的影响。了解产后体重滞留过多的驱动因素不仅可以帮助我们改善孕妇的健康状况，还可以帮助我们改善其子女的健康状况。
