新罕布什尔州出生队列研究中母乳喂养持续时间的预测因素。
Predictors of Breastfeeding Duration in the New Hampshire Birth Cohort Study.
机构信息
Environmental Studies Program, Middlebury College, 276 Bicentennial Way, Middlebury, VT, 05753, USA.
Department of Epidemiology, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA.
出版信息
Matern Child Health J. 2023 Aug;27(8):1434-1443. doi: 10.1007/s10995-023-03714-4. Epub 2023 Jun 3.
INTRODUCTION
Breastfeeding has significant health benefits for infants and birthing persons, including reduced risk of chronic disease. The American Academy of Pediatrics recommends exclusively breastfeeding infants for 6 months and recently extended its recommendation for continuing to breastfeed with supplementation of solid foods from one to two years. Studies consistently identify lower breastfeeding rates among US infants, with regional and demographic variability. We examined breastfeeding in birthing person-infant pairs among healthy, term pregnancies enrolled in the New Hampshire Birth Cohort Study between 2010 and 2017 (n = 1176).
METHODS
Birthing persons 18-45 years old were enrolled during prenatal care visits at ~ 24-28 weeks gestation and have been followed since enrollment. Breastfeeding status was obtained from postpartum questionnaires. Birthing person and infant health and sociodemographic information was abstracted from medical records and prenatal and postpartum questionnaires. We evaluated the effects of birthing person age, education, relationship status, pre-pregnancy body mass index, gestational weight gain (GWG), smoking and parity, and infant sex, ponderal index, gestational age and delivery mode on breastfeeding initiation and duration using modified Poisson and multivariable linear regression.
RESULTS
Among healthy, term pregnancies, 96% of infants were breastfed at least once. Only 29% and 28% were exclusively breastfed at 6-months or received any breastmilk at 12-months, respectively. Higher birthing person age, education, and parity, being married, excessive GWG, and older gestational age at delivery were associated with better breastfeeding outcomes. Smoking, obesity, and cesarean delivery were negatively associated with breastfeeding outcomes.
CONCLUSIONS
Given the public health importance of breastfeeding for infants and birthing persons, interventions are needed to support birthing persons to extend their breastfeeding duration.
引言
母乳喂养对婴儿和产妇有重要的健康益处，包括降低慢性病风险。美国儿科学会建议婴儿纯母乳喂养 6 个月，并最近将继续母乳喂养、添加固体食物的建议从 1 年延长至 2 年。研究一致表明，美国婴儿的母乳喂养率较低，存在地区和人口统计学差异。我们研究了 2010 年至 2017 年间参加新罕布什尔州出生队列研究的健康足月妊娠产妇-婴儿对的母乳喂养情况（n=1176）。
方法
18-45 岁的产妇在孕 24-28 周的产前检查期间入组，并自入组以来一直随访。通过产后问卷调查获取母乳喂养状况。产妇和婴儿的健康和社会人口统计学信息从医疗记录和产前及产后问卷调查中提取。我们使用修正泊松回归和多变量线性回归评估了产妇年龄、教育程度、婚姻状况、孕前 BMI、孕期体重增加（GWG）、吸烟和产次、婴儿性别、体重指数、胎龄和分娩方式对母乳喂养起始和持续时间的影响。
结果
在健康的足月妊娠中，96%的婴儿至少接受过一次母乳喂养。分别只有 29%和 28%的婴儿在 6 个月时纯母乳喂养，在 12 个月时接受任何母乳。产妇年龄较大、教育程度较高、产次较多、已婚、GWG 过多、分娩时胎龄较大与母乳喂养结局较好相关。吸烟、肥胖和剖宫产与母乳喂养结局呈负相关。
结论
鉴于母乳喂养对婴儿和产妇的公共卫生重要性，需要采取干预措施，支持产妇延长母乳喂养时间。
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