Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada.
Department of Obstetrics and Gynecology, University of Calgary, Calgary, Alberta, Canada.
Acta Obstet Gynecol Scand. 2023 Apr;102(4):420-429. doi: 10.1111/aogs.14516. Epub 2023 Jan 27.
Use of medications is a common concern for breastfeeding women, particularly when they are strongly needed or unavoidable to manage maternal chronic conditions. Yet the influence of medication usage patterns on breastfeeding duration in mothers with chronic conditions is unclear. The objective of this study was to examine whether postpartum medication practices were associated with shorter breastfeeding duration or earlier than planned breastfeeding cessation among mothers with chronic conditions.
We analyzed 346 mothers with chronic conditions enrolled in a prospective, community-based pregnancy cohort study (Alberta, Canada) who initiated breastfeeding after birth. Data were collected through self-report questionnaires spanning late pregnancy to 6 months postpartum. Based on reported use of preexisting medications while breastfeeding, women were classified as continuing medications (reference group), discontinuing one or more medications, or those who did not use preexisting medications. Cox proportional hazards regression was used to analyze the association of medication practices and overall breastfeeding duration in weeks. Logistic regression was used to analyze the association of medication practices and earlier than planned breastfeeding cessation. Multivariable models adjusted for demographic and health-related factors.
Overall, 30.6% of women with chronic conditions stopped breastfeeding in the first 6 months, almost all of whom did so earlier than planned. In multivariable models, medication discontinuation was significantly associated with shorter breastfeeding duration (adjusted hazard ratio [HR] 1.67, 95% confidence interval [CI] 1.03-2.70) and earlier than planned breastfeeding cessation (adjusted odds ratio [OR] 1.85, 95% CI 1.01-3.42), whereas medication non-use was not associated with differences in breastfeeding outcomes.
Women with chronic conditions who discontinued preexisting medications while breastfeeding had significantly shorter breastfeeding duration and were less likely to meet their breastfeeding goals in the first 6 months postpartum compared to women who continued preexisting medications.
药物使用是哺乳期妇女普遍关注的问题，尤其是当她们需要强烈使用或不可避免地使用药物来治疗慢性疾病时。然而，药物使用模式对患有慢性疾病的母亲母乳喂养持续时间的影响尚不清楚。本研究的目的是检验产后药物使用情况是否与患有慢性疾病的母亲母乳喂养持续时间更短或提前停止母乳喂养有关。
我们分析了在加拿大阿尔伯塔省进行的一项前瞻性、基于社区的妊娠队列研究中 346 名患有慢性疾病的母亲，她们在产后开始母乳喂养。数据通过妊娠晚期至产后 6 个月的自我报告问卷收集。根据报告的母乳喂养期间使用现有药物的情况，将女性分为继续使用药物（参考组）、停止使用一种或多种药物或未使用现有药物的组。使用 Cox 比例风险回归分析药物使用情况与总母乳喂养持续时间（以周为单位）的关系。使用逻辑回归分析药物使用情况与提前计划的母乳喂养停止的关系。多变量模型调整了人口统计学和健康相关因素。
总体而言，30.6%的慢性疾病母亲在头 6 个月内停止母乳喂养，几乎所有人都提前停止母乳喂养。在多变量模型中，药物停用与母乳喂养时间更短显著相关（调整后的风险比[HR] 1.67，95%置信区间[CI] 1.03-2.70）和提前计划的母乳喂养停止（调整后的比值比[OR] 1.85，95%置信区间[CI] 1.01-3.42），而不使用药物与母乳喂养结果无差异相关。
与继续使用现有药物的女性相比，患有慢性疾病的女性在母乳喂养期间停止使用现有药物，母乳喂养时间明显缩短，并且在产后头 6 个月内更不可能实现母乳喂养目标。
