Dhaurali Shubhecchha, Dugat Vickie, Whittler Tayler, Shrestha Shikhar, Kiani Marwah, Ruiz Maria Gabriela, Ali Iman, Enge Courtney, Amutah-Onukagha Ndidiamaka
Department of Community Health, Tufts University, 419 Boston Avenue, Medford, MA 02155, USA.
Maternal Outcomes for Translational Health Equity Research (MOTHER) Lab, Center for Black Maternal Health and Reproductive Justice, Tufts University School of Medicine, 136 Harrison Avenue, Boston, MA 02111, USA.
Healthcare (Basel). 2023 Jun 9;11(12):1691. doi: 10.3390/healthcare11121691.
Breastfeeding is invaluable for postpartum physical healing and mental wellbeing, but psychosocial stress and depression impede such recovery processes. To inform future interventions and policies, associations between breastfeeding, maternal stress, and depression were examined. Data from the Pregnancy Risk Assessment Monitoring System (PRAMS) were analyzed (2016-2019). Logistic regression models were used to calculate adjusted odds ratios with 95% confidence intervals. Of the total sample ( = 95,820), approximately 88% of participants attempted breastfeeding. Our findings indicate that participants who experienced any form of stress had a slightly higher likelihood of breastfeeding compared to those without stress. Specifically, partner-related and financial-related stressors were significantly associated with increased odds of breastfeeding. However, no significant associations were observed trauma-related or emotional-related stressors and breastfeeding. Additionally, no significant association was found between depression at different stages (preconception, prenatal, and postpartum) and breastfeeding. A significant interaction effect was noted between having experienced any of the 13 stressors and Black race/ethnicity on breastfeeding odds. Similarly, significant interaction effects were observed between partner-related, trauma, financial, or emotional stressors and Black race/ethnicity. These findings emphasize the importance of considering various factors when promoting breastfeeding in diverse populations, and screening for psychosocial stress during postpartum visits. Our study recommends tailoring breastfeeding interventions to address the needs of Black mothers which could significantly improve maternal health and breastfeeding outcomes.
母乳喂养对产后身体恢复和心理健康非常重要，但社会心理压力和抑郁会阻碍这种恢复过程。为了为未来的干预措施和政策提供参考，研究了母乳喂养、母亲压力和抑郁之间的关联。分析了来自妊娠风险评估监测系统（PRAMS）（2016 - 2019年）的数据。使用逻辑回归模型计算调整后的比值比及95%置信区间。在总样本（n = 95,820）中，约88%的参与者尝试进行母乳喂养。我们的研究结果表明，与没有压力的参与者相比，经历过任何形式压力的参与者进行母乳喂养的可能性略高。具体而言，与伴侣相关和与财务相关的压力源与母乳喂养几率增加显著相关。然而，未观察到与创伤相关或与情绪相关的压力源与母乳喂养之间存在显著关联。此外，在不同阶段（孕前、产前和产后）的抑郁与母乳喂养之间未发现显著关联。在经历13种压力源中的任何一种与黑人种族/族裔之间，观察到对母乳喂养几率有显著的交互作用。同样，在与伴侣相关、创伤、财务或情绪压力源与黑人种族/族裔之间也观察到显著的交互作用。这些发现强调了在不同人群中促进母乳喂养时考虑各种因素以及在产后访视期间筛查社会心理压力的重要性。我们的研究建议针对黑人母亲的需求调整母乳喂养干预措施，这可能会显著改善孕产妇健康和母乳喂养结果。
