Department of Kinesiology, College for Health, Community, and Policy, University of Texas at San Antonio, San Antonio, TX 78249, USA.
Brooke Army Medical Center, San Antonio, TX 78249, USA.
Nutrients. 2024 Sep 25;16(19):3239. doi: 10.3390/nu16193239.
Varied hospital systems demonstrate diverse and often very different approaches to patient care. This may best be analyzed by looking at specific disorders and outcomes in a population with these disorders. As one such lens, hypertensive disorders of pregnancy (HDPs) continue to pose a severe health risk for mothers and infants, and breastfeeding outcomes play a crucial role in determining long-term maternal and fetal health. This pilot study investigated breastfeeding outcomes in two hospitals, as representatives for differing healthcare systems, among patients diagnosed with HDPs. Data were collected for 12 months at two hospitals, one private and one military, on 729 patients diagnosed with HDPs. Data were analyzed for infant maturity at birth and breastfeeding outcomes. Most participants (83.2%) stated their intention to breastfeed for the first six months of life. By hospital discharge, only 56% ( = 0.0001) of the private hospital participants were breastfeeding compared to 65% of the military hospital participants. In addition, while 69% of infants were born before term, more infants were born before term at the private hospital (71%) than at the military hospital (65%), with 37% (private) and 42% (military) of preterm infants breastfeeding at hospital discharge. Significant differences existed between these two hospital systems in the number of those initiating breastfeeding and breastfeeding at hospital discharge. The military hospital was more successful in assisting these high-risk women in meeting their breastfeeding intentions. Changes in hospital practices, such as metrics and incentivization, focusing on breastfeeding support, could improve the rate of breastfeeding at hospital discharge and impact long-term health outcomes.
不同的医院系统在患者护理方面表现出不同的方法，这些方法往往非常不同。通过研究患有这些疾病的人群中的特定疾病和结果，可以最好地分析这一点。作为一个这样的视角，妊娠高血压疾病（HDP）仍然对母亲和婴儿构成严重的健康风险，母乳喂养结果在确定母婴长期健康方面起着至关重要的作用。这项试点研究调查了两家医院的母乳喂养结果，这两家医院分别代表了不同的医疗保健系统，研究对象是被诊断出患有 HDP 的患者。在两家医院（一家私立医院和一家军队医院）收集了 12 个月的 729 名被诊断出患有 HDP 的患者的数据。对婴儿出生时的成熟度和母乳喂养结果进行了数据分析。大多数参与者（83.2%）表示他们打算在生命的前六个月进行母乳喂养。到出院时，私立医院的参与者中只有 56%（=0.0001）在进行母乳喂养，而军队医院的参与者中有 65%在进行母乳喂养。此外，虽然 69%的婴儿早产，但私立医院的早产儿（71%）比军队医院的早产儿（65%）更多，出院时，37%（私立）和 42%（军队）的早产儿在进行母乳喂养。这两个医院系统在开始母乳喂养和出院时母乳喂养的人数方面存在显著差异。军队医院在帮助这些高风险妇女实现母乳喂养意愿方面更为成功。改变医院的做法，如关注母乳喂养支持的指标和激励措施，可以提高出院时母乳喂养的比例，并影响长期健康结果。
