Multidisciplinary Health Institute, Federal University of Bahia, Vitória da Conquista, Bahia, Brazil.
Department of Nutrition, Federal University of Juíz de Fora, Juíz de Fora, Minas Gerais, Brazil.
Breastfeed Med. 2023 Feb;18(2):124-131. doi: 10.1089/bfm.2022.0081.
This study aimed to investigate the association between prepregnancy obesity and disruption of exclusive breastfeeding (EBF) within the first month of life. This was a prospective cohort study conducted among Brazilian mothers and their babies born between February and December 2017. Research was conducted in all maternity hospitals in Vitória da Conquista, Brazil. Data collection started in the maternity hospitals of the city and, subsequently, an interview was conducted during a home visit on the 30th day of the child's life. Survival analysis was performed using Kaplan-Meier curves and a log rank test was applied to compare the curves. The association between independent variables and the response variable was assessed using Cox regression, following the conceptual model created for the study. The study analyzed 329 pairs of mothers and babies. The prevalence of prepregnancy obesity was 12%. The prevalence of EBF disruption in the first month of life was 41.1% in nonobese mothers (confidence interval [95% CI]: 35.3-46.9) and 52.6% in obese mothers (95% CI: 36.3-68.4), with a shorter survival time among mothers with prepregnancy obesity (log rank < 0.05). The risk of EBF disruption in the first month of life was 83% higher among mothers with prepregnancy obesity, after adjusting for confounding variables-demographic, socioeconomic, prenatal maternal data, and childbirth variables (hazard ratio = 1.84; 95% CI: 1.08-3.11). We observed an association between pregestational obesity and disruption of EBF in the first month of life. This finding reinforces the need for a thorough professional approach to the practice of breastfeeding in this population in the prenatal period as well as early puerperium.
本研究旨在探讨孕前肥胖与婴儿生命最初一个月内纯母乳喂养（EBF）中断之间的关联。这是一项在巴西母亲及其 2017 年 2 月至 12 月间出生的婴儿中开展的前瞻性队列研究。研究在巴西维多利亚达孔基斯塔的所有妇产医院进行。数据收集始于该市的妇产医院，随后在婴儿出生第 30 天进行家访时进行访谈。采用 Kaplan-Meier 曲线进行生存分析，并应用对数秩检验比较曲线。采用 Cox 回归评估独立变量与因变量之间的关联，遵循为研究创建的概念模型。该研究分析了 329 对母婴。孕前肥胖的患病率为 12%。在非肥胖母亲中，生命最初一个月 EBF 中断的患病率为 41.1%（95%置信区间 [95%CI]：35.3-46.9），肥胖母亲中为 52.6%（95%CI：36.3-68.4），孕前肥胖母亲的生存时间更短（对数秩检验 <0.05）。在校正人口统计学、社会经济状况、产前母婴数据和分娩变量等混杂因素后，孕前肥胖母亲生命最初一个月 EBF 中断的风险增加了 83%（风险比 [HR] = 1.84；95%CI：1.08-3.11）。我们观察到孕前肥胖与婴儿生命最初一个月 EBF 中断之间存在关联。这一发现强调了在产前和产后早期阶段，需要对这一人群的母乳喂养实践进行全面的专业干预。
