Crisinel Pierre Alex, Kusejko Katharina, Kahlert Christian R, Wagner Noémie, Beyer Leila Sultan, De Tejada Begoña Martinez, Hösli Irene, Vasconcelos Malte Kohns, Baumann Marc, Darling Katharine, Duppenthaler Andrea, Rauch Andri, Paioni Paolo, Aebi-Popp Karoline
Unit of Pediatric Infectious Diseases and Vaccinology, Department Women Mother Child, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
University Hospital Zurich and University of Zurich, Zurich, Switzerland.
Eur J Obstet Gynecol Reprod Biol. 2023 Apr;283:86-89. doi: 10.1016/j.ejogrb.2023.02.013. Epub 2023 Feb 15.
Swiss national recommendations advise, since end of 2018, supporting women with HIV who wish to breastfeed. Our objective is to describe the motivational factors and the outcome of these women and of their infants.
mothers included in MoCHiV with a delivery between January 2019 and February 2021 who fulfilled the criteria of the "optimal scenario" (adherence to cART, regular clinical care, and suppressed HIV plasma viral load (pVL) of <50 RNA copies/ml) and who decided to breastfeed after a shared decision-making process, were approached to participate in this nested study and asked to fill-in a questionnaire exploring the main motivating factors for breastfeeding.
Between January 9, 2019 and February 7, 2021, 41 women gave birth, and 25 decided to breastfeed of which 20 accepted to participate in the nested study. The three main motivational factors of these women were bonding, neonatal and maternal health benefits. They breastfed for a median duration of 6.3 months (range 0.7-25.7, IQR 2.5-11.1). None of the breastfed neonates received HIV post-exposure prophylaxis. There was no HIV transmission: 24 infants tested negative for HIV at least 3 months after weaning; one mother was still breastfeeding when we analyzed the data.
As a result of a shared decision-making process, a high proportion of mothers expressed a desire to breastfeed. No breastfed infant acquired HIV. The surveillance of breastfeeding mother-infant pairs in high resource settings should be continued to help update guidelines and recommendations.
自2018年底起，瑞士国家建议提倡对希望进行母乳喂养的感染艾滋病毒的女性给予支持。我们的目标是描述这些女性及其婴儿的动机因素和结果。
纳入MoCHiV研究中的母亲，她们在2019年1月至2021年2月期间分娩，符合“最佳情况”标准（坚持接受抗逆转录病毒治疗、定期临床护理且艾滋病毒血浆病毒载量（pVL）抑制至<50 RNA拷贝/毫升），并在经过共同决策过程后决定进行母乳喂养，邀请她们参与这项嵌套研究，并要求填写一份问卷，以探究母乳喂养的主要动机因素。
在2019年1月9日至2021年2月7日期间，41名女性分娩，其中25名决定进行母乳喂养，20名同意参与嵌套研究。这些女性母乳喂养的三个主要动机因素是母婴情感联结、对新生儿和母亲健康有益。她们的母乳喂养持续时间中位数为6.3个月（范围0.7 - 25.7个月，四分位间距2.5 - 11.1个月）。所有母乳喂养的新生儿均未接受暴露后预防用药。没有发生艾滋病毒传播：24名婴儿在断奶后至少3个月的艾滋病毒检测呈阴性；在我们分析数据时，有一名母亲仍在进行母乳喂养。
经过共同决策过程，很大比例的母亲表示希望进行母乳喂养。没有母乳喂养的婴儿感染艾滋病毒。应继续对资源丰富环境中的母乳喂养母婴对进行监测，以帮助更新指南和建议。
