Ayuby Nadia Azlan, Ang Mei Qi, Sultana Rehena, Tan Chin Wen, Sng Ban Leong
Department of Women's Anesthesia, KK Women's and Children's Hospital, 100 Bukit Timah Road, Singapore, 229899, Singapore.
Division of Nursing, KK Women's and Children's Hospital, Singapore, Singapore.
Sci Rep. 2024 Dec 28;14(1):31361. doi: 10.1038/s41598-024-82850-5.
Mothers encounter several challenges to sustain breastfeeding until the recommended 6 months of age. There is limited evidence on the impact of women's labor pain experiences upon cessation of breastfeeding. We aimed to investigate the association between women's labor pain experiences, intrapartum interventions, and pre-birth psychological vulnerabilities and cessation of breastfeeding. This was a secondary analysis of a clinical trial conducted in a tertiary hospital in Singapore between June 2017 and July 2021. Data were obtained from participants, electronic records and surveys administered before delivery, and postpartum 6-10 weeks. A total of 624 (76.8%) women were still breastfeeding at postpartum 6-10 weeks as compared to 189 (23.2%) that had discontinued breastfeeding. Multivariable regression analysis identified lower education level (aOR 3.88, 95% CI 2.57-5.85, p < 0.0001), having diabetes (aOR, 95% CI 1.21-5.44, p = 0.0141), presence of obstetric complications (aOR 1.57, 95% CI 1.00-2.46, p = 0.0494), artificial rupture of membrane (ARM) and oxytocin induction (aOR 2.07, 95% CI 1.22-3.50, p = 0.0068), lower age (aOR 0.92, 95% CI 0.88-0.97, p = 0.0010) and higher A-LPQ birth pain score (aOR 1.02, 95% CI 1.01-1.04, p = 0.0064) as independent associations with cessation of breastfeeding at postpartum 6-10 weeks, with AUC of the model being 0.72 (95% CI 0.68-0.77). Higher pain experienced during labor is associated with cessation of breastfeeding among several other intrapartum interventions and psychological vulnerabilities. Using risk stratification strategy, breastfeeding support services could be provided to women to optimize successful breastfeeding in the postpartum period.Trial registration: This study was registered on Clinicaltrials.gov NCT03167905 on 30/05/2017.
母亲们在坚持母乳喂养至推荐的6个月龄时会遇到诸多挑战。关于女性分娩疼痛经历对母乳喂养停止的影响，证据有限。我们旨在调查女性分娩疼痛经历、产时干预措施以及产前心理脆弱性与母乳喂养停止之间的关联。这是对2017年6月至2021年7月在新加坡一家三级医院进行的一项临床试验的二次分析。数据来自参与者、分娩前及产后6 - 10周进行的电子记录和调查。产后6 - 10周时，共有624名（76.8%）女性仍在进行母乳喂养，相比之下，189名（23.2%）女性已停止母乳喂养。多变量回归分析确定，较低的教育水平（调整后比值比[aOR] 3.88，95%置信区间[CI] 2.57 - 5.85，p < 0.0001）、患有糖尿病（aOR，95% CI 1.21 - 5.44，p = 0.0141）、存在产科并发症（aOR 1.57，95% CI 1.00 - 2.46，p = 0.0494）、人工破膜（ARM）和催产素引产（aOR 2.07，95% CI 1.22 - 3.50，p = 0.0068）、较低的年龄（aOR 0.92，95% CI 0.88 - 0.97，p = 0.0010）以及较高的A - LPQ分娩疼痛评分（aOR 1.02，95% CI 1.01 - 1.04，p = 0.0064）是产后6 - 10周母乳喂养停止的独立相关因素，模型的曲线下面积（AUC）为0.72（95% CI 0.68 - 0.77）。在其他几种产时干预措施和心理脆弱性因素中，分娩时经历的较高疼痛与母乳喂养停止有关。采用风险分层策略，可以为女性提供母乳喂养支持服务，以优化产后成功母乳喂养。试验注册：本研究于2017年5月30日在Clinicaltrials.gov上注册，注册号为NCT03167905。
