Johnson Tricia J, Meier Paula P, Robinson Daniel T, Suzuki Sumihiro, Kadakia Suhagi, Garman Andrew N, Patel Aloka L
Department of Health Systems Management, Rush University, Chicago, IL 60612, USA.
College of Nursing, Rush University, Chicago, IL 60612, USA.
Children (Basel). 2023 Feb 21;10(3):416. doi: 10.3390/children10030416.
In the United States, 10% of infants are born preterm (PT; <37 weeks gestational age) each year and are at higher risk of complications compared to full term infants. The burden of PT birth is borne disproportionately by Black versus non-Black families, with Black mothers significantly more likely to give birth to a PT infant. One proven strategy to improve short- and long-term health outcomes in PT infants is to feed mother's own milk (MOM; breast milk from the mother). However, mothers must make decisions about work and MOM provision following PT birth, and more time spent in paid work may reduce time spent in unpaid activities, including MOM provision. Non-Black PT infants are substantially more likely than Black PT infants to receive MOM during the birth hospitalization, and this disparity is likely to be influenced by the complex decisions mothers of PT infants make about allocating their time between paid and unpaid work. Work is a social determinant of health that provides a source of income and health insurance coverage, and at the same time, has been shown to create disparities through poorer job quality, lower earnings, and more precarious employment in racial and ethnic minority populations. However, little is known about the relationship between work and disparities in MOM provision by mothers of PT infants. This State of the Science review synthesizes the literature on paid and unpaid work and MOM provision, including: (1) the complex decisions that mothers of PT infants make about returning to work, (2) racial and ethnic disparities in paid and unpaid workloads of mothers, and (3) the relationship between components of job quality and duration of MOM provision. Important gaps in the literature and opportunities for future research are summarized, including the generalizability of findings to other countries.
在美国，每年有10%的婴儿早产（孕周<37周），与足月儿相比，他们出现并发症的风险更高。早产的负担在黑人家庭和非黑人家庭之间的分布不均衡，黑人母亲生下早产婴儿的可能性显著更高。改善早产婴儿短期和长期健康结局的一个已被证实的策略是喂养母亲自己的母乳（MOM；母亲的母乳）。然而，母亲在早产之后必须就工作和提供母乳做出决定，花在有偿工作上的时间增加可能会减少花在无偿活动上的时间，包括提供母乳。与黑人早产婴儿相比，非黑人早产婴儿在出生住院期间接受母乳的可能性要高得多，这种差异可能受到早产婴儿母亲在有偿和无偿工作之间分配时间时所做的复杂决定的影响。工作是健康的一个社会决定因素，它提供了收入来源和医疗保险，同时，研究表明，工作会通过较差的工作质量、较低的收入以及种族和少数民族人口中更不稳定的就业情况导致差异。然而，关于工作与早产婴儿母亲提供母乳方面的差异之间的关系，我们知之甚少。本科学现状综述综合了关于有偿和无偿工作以及提供母乳的文献，包括：（1）早产婴儿母亲关于重返工作岗位所做的复杂决定，（2）母亲有偿和无偿工作量方面的种族和民族差异，以及（3）工作质量组成部分与提供母乳持续时间之间的关系。总结了文献中的重要空白以及未来研究的机会，包括研究结果对其他国家的可推广性。
