School of Nursing, Wuhan University, Wuhan, China.
Department of Critical Care Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China.
Breastfeed Med. 2023 Jun;18(6):431-448. doi: 10.1089/bfm.2022.0237. Epub 2023 Jun 6.
Although the beneficial effects of exclusive breastfeeding (EBF) on infants and mothers have been identified, EBF rates remain unsatisfactory. Co-parenting interventions for perinatal couples have not been systematically evaluated and analyzed for their effects on breastfeeding outcomes. To systematically evaluate the effects of co-parenting interventions on the rate of EBF, breastfeeding knowledge, breastfeeding attitude, breastfeeding self-efficacy, parental relationship, and partner support. Randomized controlled trials and quasi-experimental studies were systematically screened in eight online databases from inception to November 2022. Trials included in this review were assessed using the Cochrane Risk of Bias Assessment Tool. Eligible trials were used to conduct a meta-analysis using Review Manager software. The statistic was used to assess heterogeneity between studies. When it was not possible to conduct a meta-analysis, a descriptive analysis was used to present the findings due to insufficient data from the included studies. Fifteen of the 1,869 articles reviewed met the inclusion criteria. Co-parenting interventions significantly improved the EBF rate at 16 weeks (odds ratio [] 3.85, 95% confidence interval, CI [1.84 to 8.03], < 0.001, = 69%) and 6 months ( = 2.82, 95% CI [1.47 to 5.41], = 0.002, = 85%). This study revealed that co-parenting interventions made statistically significant improvements in parental relationship (standardized mean difference [] = 0.26, 95% CI [0.13 to 0.38], < 0.001, = 80%). There was no evidence of the effectiveness of interventions in terms of overall parental support ( = 0.75, 95% CI [-0.46 to 1.97], 0.001, = 96%). Given the discrepant and limited research data, findings on breastfeeding knowledge, breastfeeding attitudes, and breastfeeding self-efficacy were presented descriptively. Co-parenting interventions effectively increase EBF rates at 16 weeks and 6 months postpartum, and improve breastfeeding knowledge, breastfeeding attitude, and parental relationships.
虽然已经确定了纯母乳喂养(EBF)对婴儿和母亲的有益影响,但 EBF 的比例仍然不尽如人意。针对围产期夫妇的共同养育干预措施尚未系统评估和分析其对母乳喂养结果的影响。本研究旨在系统评估共同养育干预措施对 EBF 率、母乳喂养知识、母乳喂养态度、母乳喂养自我效能、父母关系和伴侣支持的影响。从研究开始到 2022 年 11 月,系统地在八个在线数据库中筛选了随机对照试验和准实验研究。本综述中纳入的试验使用 Cochrane 偏倚风险评估工具进行评估。使用 Review Manager 软件对合格试验进行荟萃分析。使用 统计量评估研究之间的异质性。由于纳入研究的数据不足,无法进行荟萃分析时,使用描述性分析来呈现研究结果。在审查的 1869 篇文章中,有 15 篇符合纳入标准。共同养育干预措施显著提高了 16 周(比值比 [OR] 3.85,95%置信区间,CI [1.84 至 8.03], < 0.001, = 69%)和 6 个月(OR 2.82,95% CI [1.47 至 5.41], = 0.002, = 85%)的 EBF 率。这项研究表明,共同养育干预措施在父母关系方面取得了统计学上的显著改善(标准化均数差 [SMD] 0.26,95%置信区间 [0.13 至 0.38], < 0.001, = 80%)。干预措施在整体父母支持方面的有效性没有证据(SMD 0.75,95%置信区间 [-0.46 至 1.97], 0.001, = 96%)。鉴于研究数据存在差异且有限,因此对母乳喂养知识、母乳喂养态度和母乳喂养自我效能的结果进行了描述性呈现。共同养育干预措施可有效提高产后 16 周和 6 个月的 EBF 率,并改善母乳喂养知识、母乳喂养态度和父母关系。