Wicklund Lorena, Epstein Allison, Szugye Heidi, Schleicher Mary, Lam Suet Kam
Case Western Reserve University School of Medicine, the Cleveland Clinic Lerner College of Medicine, and the Cleveland Clinic Foundation, Cleveland Ohio.
Obstet Gynecol. 2024 Apr 1;143(4):e107-e124. doi: 10.1097/AOG.0000000000005502. Epub 2024 Jan 11.
To perform a systematic review to assess the association between the length of maternity leave and breastfeeding duration in the United States.
This review was conducted with a five-stage model for reviews. We included publications from 2000 to 2023, U.S.-based studies written in English, and primary research and peer-reviewed articles. In February 2023, a medical librarian conducted a search across seven databases, yielding 1,540 results. ClinicalTrials.gov was later searched, yielding no results. After duplicates were removed, 835 abstracts were screened. A full-text article review was then conducted of the remaining 34 articles.
TABULATION, INTEGRATION, AND RESULTS: Twenty-three articles met inclusion criteria, two of which were reviews. Of the nonreview articles, all found a positive relationship between increased maternity leave and duration of breastfeeding. Data showed that earlier return to work for the birth parent decreased the odds of breastfeeding dyads meeting breastfeeding recommendations. Many studies adjusted for confounders (eg, race, socioeconomic status); however, Black or Latinx mothers still experience shorter breastfeeding durations or lower breastfeeding exclusivity when given equal leave compared with White mothers.
Results show a positive relationship between length of maternity leave and breastfeeding duration. Advocacy for longer, paid parental leave and more robust research rooted in rigorous methods are needed.
进行一项系统评价，以评估美国产假时长与母乳喂养持续时间之间的关联。
本评价采用五阶段评价模型进行。我们纳入了2000年至2023年的出版物、以英文撰写的美国研究以及原创研究和同行评审文章。2023年2月，一名医学图书馆员在七个数据库中进行了检索，得到1540条结果。随后对ClinicalTrials.gov进行了检索，未得到结果。去除重复项后，筛选了835篇摘要。然后对其余34篇文章进行了全文审查。
制表、整合与结果：23篇文章符合纳入标准，其中两篇为综述。在非综述文章中，所有文章都发现产假增加与母乳喂养持续时间之间存在正相关关系。数据显示，生育父母更早重返工作岗位会降低母乳喂养二元组达到母乳喂养建议的几率。许多研究对混杂因素（如种族、社会经济地位）进行了调整；然而，与白人母亲相比，黑人或拉丁裔母亲在享有同等产假时，母乳喂养持续时间仍然较短或纯母乳喂养率较低。
结果表明产假时长与母乳喂养持续时间之间存在正相关关系。需要倡导更长时间的带薪育儿假，并开展更多基于严谨方法的有力研究。
